Provider Demographics
NPI:1437436110
Name:YOUNG, SARA LYNN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRIENDSHIP
Mailing Address - State:NY
Mailing Address - Zip Code:14739-8701
Mailing Address - Country:US
Mailing Address - Phone:585-973-3311
Mailing Address - Fax:585-973-2023
Practice Address - Street 1:46 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRIENDSHIP
Practice Address - State:NY
Practice Address - Zip Code:14739-8701
Practice Address - Country:US
Practice Address - Phone:585-973-3311
Practice Address - Fax:585-973-2023
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020741235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist