Organization
BREAKING BOUNDARIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY E YOUNG MS CCC-SLP (MANAGER)
(601) 319-4056
Entity
Organization
Contact information
Practice address
471 HIGHWAY 590, ELLISVILLE, MS 39437-8241
(601) 319-4056
Mailing address
471 HIGHWAY 590, ELLISVILLE, MS 39437-8241
(601) 319-4056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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