Provider Demographics
NPI:1376103499
Name:YOUNT, BRYCE TAYLOR (MS)
Entity Type:Individual
Prefix:MRS
First Name:BRYCE
Middle Name:TAYLOR
Last Name:YOUNT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11335 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-5219
Mailing Address - Country:US
Mailing Address - Phone:623-398-5534
Mailing Address - Fax:
Practice Address - Street 1:2532 N 4TH ST # 481
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3712
Practice Address - Country:US
Practice Address - Phone:928-226-1563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist