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Individual

MS. KRISTIN ANN YOUNGDAHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
9553 WALLEY AVE, PHILADELPHIA, PA 19115-3009
(215) 605-3186
(215) 677-3279
Mailing address
9553 WALLEY AVE, PHILADELPHIA, PA 19115-3009
(215) 605-3186
(215) 677-3279

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SL004231L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101667233
MEDICAL ASSISTANCE NUMBER
PA
Enumeration date
07/05/2007
Last updated
07/08/2007
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