MEDICARE: SONYA YOUNG

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1104423524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONYA YOUNG

Provider Business Mailing Address
First Line	:	3444 INWOOD CIR W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5518
Country	:	US
Telephone Number	:	904-803-1285
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 BRIDIER ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32206-5904
Country	:	US
Telephone Number	:	904-646-4889
Fax Number	:

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

Provider Enumeration Date	:	10/08/2020
Last Update Date	:	10/08/2020

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Directions to “ SONYA YOUNG ” Practice Location

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