Provider Demographics
NPI:1346230745
Name:YOUNG, JARED RYAN (MS FAAA CAAA)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:RYAN
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MS FAAA CAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:98 N 1100 E STE 203
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2941
Practice Address - Country:US
Practice Address - Phone:801-492-2445
Practice Address - Fax:801-492-2470
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5151504-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist