MEDICARE: MR. ABRAM OWEN YOUNG

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		AZ

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	:	1871775676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ABRAM OWEN YOUNG

Provider Business Mailing Address
First Line	:	75 E 250 N
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84770-2847
Country	:	US
Telephone Number	:	435-673-5048
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 N COTTONWOOD
Second Line	:	COLORADO CITY UNIFIED SCHOOL DISTRICT #14
City	:	COLORADO CITY
State	:	AZ
Zip	:	86021
Country	:	US
Telephone Number	:	928-875-9000
Fax Number	:

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

Provider Enumeration Date	:	12/04/2007
Last Update Date	:	12/10/2007

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Directions to “ MR. ABRAM OWEN YOUNG ” Practice Location

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