Provider Demographics
NPI:1518856921
Name:YOUNG, DEJA MONET
Entity type:Individual
Prefix:
First Name:DEJA
Middle Name:MONET
Last Name:YOUNG
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 1:3939 W 12TH ST APT 1407
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7372
Mailing Address - Country:US
Mailing Address - Phone:443-939-2375
Mailing Address - Fax:
Practice Address - Street 1:3939 W 12TH ST APT 1407
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7372
Practice Address - Country:US
Practice Address - Phone:443-939-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist