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NPI Code Detail

MEDICARE: GESSYKA YOUNG M.A., CCC/SLP

MEDICARE: GESSYKA YOUNG M.A., 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
1235Z00000XSpeech-Language PathologistSA 7117FL
2235Z00000XSpeech-Language PathologistSLP008482GA

Other Identifiers

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

General Provider Information

NPI Number : 1992863468
Entity Type Code : Individual
Provider Name (Legal Business Name) : GESSYKA YOUNG M.A., CCC/SLP
Provider Business Mailing Address
First Line : 400 GUNSTON HALL DR
Second Line :
City : MILTON
State : GA
Zip : 30004-7504
Country : US
Telephone Number : 407-701-5910
Fax Number :
Provider Business Practice Location Address
First Line : 9880 HICKORY FLAT HWY
Second Line :
City : WOODSTOCK
State : GA
Zip : 30188-3081
Country : US
Telephone Number : 770-800-5828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 03/14/2023

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