Provider Demographics
NPI:1427485713
Name:MANKE YOUNG, KARA VON (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:VON
Last Name:MANKE YOUNG
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-5942
Mailing Address - Country:US
Mailing Address - Phone:405-895-6819
Mailing Address - Fax:405-794-2385
Practice Address - Street 1:424 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-5942
Practice Address - Country:US
Practice Address - Phone:405-895-6819
Practice Address - Fax:405-794-2385
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist