Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003003989 |
---|---|
Provider Name | Michelle Loreen Young |
First Address | Carson City, NV 89703-1541 |
Second Address | Carson City, NV 89703-1541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 25/09/2007 |