Basic Information
| Provider Information | |||||||||
| NPI: | 1245647502 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOUNG | ||||||||
| FirstName: | DONNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 872 GENERAL PULLER HWY | ||||||||
| Address2: | #101 | ||||||||
| City: | SALUDA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047589398 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5372B OLD VIRGINIA ST | ||||||||
| Address2: | |||||||||
| City: | URBANNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231752179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047585250 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2014 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2202008771 | VA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.