Provider Demographics
NPI:1457147449
Name:YOUNG, LAUREN MADISON (BS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MADISON
Last Name:YOUNG
Suffix:
Gender:
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:884 REGENTS PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-9762
Mailing Address - Country:US
Mailing Address - Phone:734-790-9805
Mailing Address - Fax:
Practice Address - Street 1:2000 SHERMAN CIR NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-5219
Practice Address - Country:US
Practice Address - Phone:330-830-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist