Provider Demographics
NPI:1639424856
Name:YOUNG, SUSANNE SYLVIA (SI/TSHH)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:SYLVIA
Last Name:YOUNG
Suffix:
Gender:F
Credentials:SI/TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 BUCK ROAD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:917-415-8122
Mailing Address - Fax:215-357-1013
Practice Address - Street 1:1820 BUCK RD
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-2214
Practice Address - Country:US
Practice Address - Phone:917-415-8122
Practice Address - Fax:215-357-1013
Is Sole Proprietor?:No
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3998310312355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant