Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath |
NPI | 1124168604 |
---|---|
Provider Name | Meredith L Young |
First Address | Shorewood, WI 53211-1555 |
Second Address | Shorewood, WI 53211-1662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |