Provider Demographics
NPI:1669679551
Name:YOUNG, TINA SLIDER (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:SLIDER
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 S MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-9552
Mailing Address - Country:US
Mailing Address - Phone:303-814-1598
Mailing Address - Fax:
Practice Address - Street 1:1438 S MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-9552
Practice Address - Country:US
Practice Address - Phone:303-814-1598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist