Provider Demographics
NPI:1942652573
Name:HENSON YOUNG, DONNA MECHELLE (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MECHELLE
Last Name:HENSON YOUNG
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MECHELLE
Other - Last Name:HENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP-CCC
Mailing Address - Street 1:1716 DECATUR CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6500
Mailing Address - Country:US
Mailing Address - Phone:615-498-8101
Mailing Address - Fax:
Practice Address - Street 1:1716 DECATUR CIR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6500
Practice Address - Country:US
Practice Address - Phone:615-498-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2607235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist