Provider Demographics
NPI:1073660718
Name:YOUNG, CYNTHIA A (MSE, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:A
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MSE, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 W MARKHAM ST # 216
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2195
Mailing Address - Country:US
Mailing Address - Phone:501-772-7771
Mailing Address - Fax:501-694-9463
Practice Address - Street 1:10201 W MARKHAM ST # 216
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2195
Practice Address - Country:US
Practice Address - Phone:501-772-7771
Practice Address - Fax:501-694-9463
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR01037843235Z00000X
AR470235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116098721Medicaid
AR5S292OtherBCBS