Provider Demographics
NPI:1124221825
Name:HACKING-YOUNG, MEREDITH (SLP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:HACKING-YOUNG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3240
Mailing Address - Country:US
Mailing Address - Phone:316-833-1591
Mailing Address - Fax:316-295-4713
Practice Address - Street 1:410 N ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3240
Practice Address - Country:US
Practice Address - Phone:316-833-1591
Practice Address - Fax:316-295-4713
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist