Provider Demographics
NPI:1578855862
Name:YOUNG ALERS, INGRID C
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:C
Last Name:YOUNG ALERS
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 1:200 CALLE ALCALA APT 401B
Mailing Address - Street 2:COLLEGE PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3913
Mailing Address - Country:US
Mailing Address - Phone:787-310-4066
Mailing Address - Fax:
Practice Address - Street 1:URB CANA PP14 CALLE 5
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00957
Practice Address - Country:UM
Practice Address - Phone:787-998-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist