Provider Demographics
NPI:1477726602
Name:YOUNG, REBECCA E (AUD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:E
Last Name:YOUNG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:E
Other - Last Name:BENJAMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1020 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8009
Mailing Address - Country:US
Mailing Address - Phone:812-473-6093
Mailing Address - Fax:812-476-5118
Practice Address - Street 1:1020 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8009
Practice Address - Country:US
Practice Address - Phone:812-473-6093
Practice Address - Fax:812-476-5118
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000693231H00000X
IN23002497A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist