Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH 10168 | FL |
NPI | 1003123068 |
---|---|
Provider Name | Adia Smith Young |
First Address | Miami, FL 33157-1800 |
Second Address | Miami, FL 33157-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2010 |
Last Update Date | 10/09/2010 |