Provider Demographics
NPI:1154742401
Name:YOUNG, DEBORAH
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 E OSAGE RD STE F
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2091
Mailing Address - Country:US
Mailing Address - Phone:316-789-9200
Mailing Address - Fax:316-789-9212
Practice Address - Street 1:1747 E OSAGE RD
Practice Address - Street 2:SUITE F
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-3059
Practice Address - Country:US
Practice Address - Phone:316-789-9200
Practice Address - Fax:316-789-9212
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1382237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist