Provider Demographics
NPI:1518201003
Name:YOUNG, LEANN (MS, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 W ASHBY DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6055
Mailing Address - Country:US
Mailing Address - Phone:208-695-8342
Mailing Address - Fax:208-642-1315
Practice Address - Street 1:1019 3RD AVE S
Practice Address - Street 2:
Practice Address - City:PAYETTE
Practice Address - State:ID
Practice Address - Zip Code:83661-2832
Practice Address - Country:US
Practice Address - Phone:208-642-4455
Practice Address - Fax:208-642-1315
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDTSLP2282235Z00000X
OR14060235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist