MEDICARE: MRS. SAMANTHA WAGNER YUNG AU.D.

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	237600000X	Audiologist-Hearing Aid Fitter	A-1019	WY
2	231H00000X	Audiologist	A-1019	WY
3	231HA2400X	Assistive Technology Practitioner Audiologist	A-1019	WY
4	235500000X	Speech/Language/Hearing Specialist/Technologist	A-1019	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780035352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SAMANTHA WAGNER YUNG AU.D.

Provider Business Mailing Address
First Line	:	7215 COMMONS CIR UNIT C
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009-2666
Country	:	US
Telephone Number	:	307-426-4327
Fax Number	:

Provider Business Practice Location Address
First Line	:	7215 COMMONS CIR UNIT C
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009-2666
Country	:	US
Telephone Number	:	307-426-4327
Fax Number	:

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

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	11/16/2020

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