MEDICARE: JENNIFER YOUNG CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP014174	GA

General Provider Information

NPI Number	:	1225962251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER YOUNG CCC-SLP

Provider Business Mailing Address
First Line	:	9410 INDIAN SPRINGS DR
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-5031
Country	:	US
Telephone Number	:	301-442-0162
Fax Number	:

Provider Business Practice Location Address
First Line	:	2655 DALLAS HWY SW STE 320
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-7518
Country	:	US
Telephone Number	:	404-556-5554
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ JENNIFER YOUNG CCC-SLP” Practice Location

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