Provider Demographics
NPI:1851753586
Name:YOUNG, CAROLINE (SPEECH PATHOLOGY)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGY
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:ELIZABETH
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SPEECH PATHOLOGY
Mailing Address - Street 1:1007 GOODYEAR AVE
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1195
Mailing Address - Country:US
Mailing Address - Phone:256-413-6060
Mailing Address - Fax:256-413-6066
Practice Address - Street 1:1007 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1195
Practice Address - Country:US
Practice Address - Phone:256-413-6060
Practice Address - Fax:256-413-6066
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3931235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3931OtherLICENSE NUMBER