Individual
AMY E YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
471 HWY 590, ELLISVILLE, MS 39437
(601) 319-4046
Mailing address
471 HWY 590, ELLISVILLE, MS 39157-5120
(601) 319-4056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3340
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S3340
MS LICENSE
MS
Enumeration date
05/26/2009
Last updated
09/10/2012
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