Provider Demographics
NPI:1003242868
Name:YOUNG, NANCY (SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:ZARNOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:7 SLINGERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1804
Mailing Address - Country:US
Mailing Address - Phone:739-694-6832
Mailing Address - Fax:
Practice Address - Street 1:7 SLINGERLAND AVE
Practice Address - Street 2:
Practice Address - City:PEQUANNOCK
Practice Address - State:NJ
Practice Address - Zip Code:07440
Practice Address - Country:US
Practice Address - Phone:739-694-6832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2018-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013406235Z00000X
NJ41YS00738000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
12140092OtherASHA