Audrey Gwen Young, ED.D

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

33710 Issued in TX

Practice address

421 N Fredonia St
Nacogdoches, TX 75961-5010

Phone

(936) 569-3150

NPI assigned

Jun 15, 2023

Last updated

Jun 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1205510518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2683",
            "city": "TRINITY",
            "state": "TX",
            "postal_code": "758622683",
            "telephone_number": "936-569-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N FREDONIA ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615010",
            "telephone_number": "936-569-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AUDREY",
        "middle_name": "GWEN",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "33710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kangni Wu
• Stephen Edward Wyatt, PHARMD, RPH
• Xiomara Velazco, M.D. P.a.
• Darrell G Yarbrough, LCSW
• Emma Yeager, LCSW
• James R Young, M.D.
• Timothy Noel Young, MD
• Gustave Walter Younger III, ATC, LAT
• Richard Zapata, CRNA
• Cara Zou, DDS

• Speech-Language Assistant in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Speech-Language Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.