Provider Demographics
NPI:1063087625
Name:YOUNG, CELIA (CCC- SLP)
Entity type:Individual
Prefix:
First Name:CELIA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CCC- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 ALBION ST APT 203
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2378
Mailing Address - Country:US
Mailing Address - Phone:917-843-7575
Mailing Address - Fax:
Practice Address - Street 1:1958 ELM ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1247
Practice Address - Country:US
Practice Address - Phone:303-333-4982
Practice Address - Fax:187-750-6058
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000761235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist