Provider Demographics
NPI:1306211024
Name:YOUNG, DEBORAH DENISE (MACCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:DENISE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MACCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 EAST MOSES
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023
Mailing Address - Country:US
Mailing Address - Phone:918-225-5600
Mailing Address - Fax:918-225-3026
Practice Address - Street 1:316 N. STEELE AVE
Practice Address - Street 2:CUSHING UPPER ELEMENTARY
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023
Practice Address - Country:US
Practice Address - Phone:918-225-4497
Practice Address - Fax:918-225-3026
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK570235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist