Individual
KRISTINE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4922 LASALLE RD, BUILDING-B, HYATTSVILLE, MD 20782-3302
(301) 864-2333
(877) 828-2060
Mailing address
3400 LAKESIDE VIEW DR, FALLS CHURCH, VA 22041-2448
(714) 743-0414
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06581
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447657507
NPI TYPE 2 (ORGANIZATION NPI)
MD
05
—
4374045-00
—
MD
01
—
46-3684374
TAX ID
MD
Enumeration date
06/06/2012
Last updated
12/01/2016
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