Provider Demographics
NPI:1336652072
Name:YOUNG, KRISTYN EVELYN (MS)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:EVELYN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:EVELYN
Other - Last Name:STANFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2315 HIGH MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4319
Mailing Address - Country:US
Mailing Address - Phone:630-428-6900
Mailing Address - Fax:630-428-6901
Practice Address - Street 1:2315 HIGH MEADOW RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4319
Practice Address - Country:US
Practice Address - Phone:630-428-6900
Practice Address - Fax:630-428-6901
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.013973235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist