Provider Demographics
NPI:1912410507
Name:YOUNG, EMILY ANNE (MS, SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:MANNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, SLP
Mailing Address - Street 1:1 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4266
Mailing Address - Country:US
Mailing Address - Phone:864-572-7001
Mailing Address - Fax:864-412-0436
Practice Address - Street 1:1 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4266
Practice Address - Country:US
Practice Address - Phone:864-572-7001
Practice Address - Fax:864-412-0436
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty