Provider Demographics
NPI:1518396050
Name:YOUNG STRIDES INC
Entity Type:Organization
Organization Name:YOUNG STRIDES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-416-6963
Mailing Address - Street 1:3599 W LAKE MARY BLVD
Mailing Address - Street 2:STE 1B4
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3417
Mailing Address - Country:US
Mailing Address - Phone:407-416-6963
Mailing Address - Fax:
Practice Address - Street 1:3599 W LAKE MARY BLVD
Practice Address - Street 2:STE 1B4
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3417
Practice Address - Country:US
Practice Address - Phone:407-416-6963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty