Individual
INDIGO YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
11 ISLAND VIEW PL, DORCHESTER, MA 02125-3262
(617) 935-7562
Mailing address
16 ISLAND VIEW PL APT 119, BOSTON, MA 02125-3245
(617) 935-7562
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14066940
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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