Provider Demographics
NPI:1760557599
Name:OUYOUNG, LAISHYANG (SLP)
Entity Type:Individual
Prefix:MS
First Name:LAISHYANG
Middle Name:
Last Name:OUYOUNG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:
Other - Last Name:OUYOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:120 N DOHENY DR APT 204
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2819
Mailing Address - Country:US
Mailing Address - Phone:323-552-8136
Mailing Address - Fax:
Practice Address - Street 1:1500 SAN PABLO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5313
Practice Address - Country:US
Practice Address - Phone:323-442-8928
Practice Address - Fax:323-442-8528
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP5899235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist