MEDICARE: CHRISTINA YOUNG MA, BCBA, LBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1053922278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA YOUNG MA, BCBA, LBA

Provider Business Mailing Address
First Line	:	24998 SORTERS RD
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-4717
Country	:	US
Telephone Number	:	832-257-9398
Fax Number	:

Provider Business Practice Location Address
First Line	:	2045 SPRING STUEBNER RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-4812
Country	:	US
Telephone Number	:	817-562-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	08/08/2023

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