Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201010552 | MI |
NPI | 1477101921 |
---|---|
Provider Name | Mr. Corey M Youngs |
First Address | Ann Arbor, MI 48104-5131 |
Second Address | Ann Arbor, MI 48104-5131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2019 |
Last Update Date | 28/08/2019 |