Provider Demographics
NPI:1194603308
Name:YOUNG, WHITTNI PAIGE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:WHITTNI
Middle Name:PAIGE
Last Name: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 1:35776 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-9579
Mailing Address - Country:US
Mailing Address - Phone:405-207-1188
Mailing Address - Fax:
Practice Address - Street 1:35776 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-9579
Practice Address - Country:US
Practice Address - Phone:405-207-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40129235Z00000X
OK5602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist