| Doctor Name: | MS. SUSAN YOUNGDALE |
| NPI Number: | 1215373287 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP-M.A. |
| License Number: | SP 8885 |
| Business Practice Address: | 1194 Pacific St. Suite 100 San Luis Obispo, CA - 934013342 |
| Business Phone Number: | 8052341055 |
| Business Fax Number: | 8054162422 |
| Mailing Address: | 1194 Pacific St., Suite 100 SAN LUIS OBISPO |
| State: | CA |
| Postal Code: | 934013342 |
| Phone Number: | 8052341055 |
| Fax Number: | 8054162422 |
| NPI Enumeration Date: | 05/17/2013 |
| NPI Last Update Date: | 05/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP 8885 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |