Provider Demographics
NPI:1972030831
Name:YOUNG, KELSEY MARIE (MS SLP)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:MARIE
Other - Last Name:HEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS SLP
Mailing Address - Street 1:2711 CAPITAL MEDICAL BLVD. SUITE E
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4446
Mailing Address - Country:US
Mailing Address - Phone:850-322-8709
Mailing Address - Fax:850-210-0373
Practice Address - Street 1:2711 CAPITAL MEDICAL BLVD. SUITE E
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4446
Practice Address - Country:US
Practice Address - Phone:850-322-8709
Practice Address - Fax:850-210-0373
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist