Provider Demographics
NPI:1831974765
Name:YOUNG, JANET L (SLP/A-CCC)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:F
Credentials:SLP/A-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 OLD MAIN HL
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84322-6810
Mailing Address - Country:US
Mailing Address - Phone:435-999-9122
Mailing Address - Fax:
Practice Address - Street 1:6810 OLD MAIN HL
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84322-6810
Practice Address - Country:US
Practice Address - Phone:435-999-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12229644-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist