Provider Demographics
NPI:1437737426
Name:YOUNG, ALLIE ARDOIN (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:ALLIE
Middle Name:ARDOIN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5626 PRESTON OAKS RD APT 41B
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8418
Mailing Address - Country:US
Mailing Address - Phone:972-523-1972
Mailing Address - Fax:
Practice Address - Street 1:5626 PRESTON OAKS RD APT 41B
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-8418
Practice Address - Country:US
Practice Address - Phone:972-523-1972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116694235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist