Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 0255 | AZ |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0255 | AZ |
NPI | 1669760583 |
---|---|
Provider Name | Suzanne M. Young |
First Address | Tucson, AZ 85715-4214 |
Second Address | Tucson, AZ 85715-4214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2011 |
Last Update Date | 12/07/2011 |