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NPI Code Detail

MEDICARE: MRS. JANE ALICE YOUNG MSW

MEDICARE:  MRS. JANE ALICE YOUNG  MSW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1104920743
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANE ALICE YOUNG MSW
Provider Business Mailing Address
First Line : 1555 S. LAYTON BLVD.
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215
Country : US
Telephone Number : 414-902-2369
Fax Number :
Provider Business Practice Location Address
First Line : 1555 S LAYTON BLVD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-1924
Country : US
Telephone Number : 414-902-2369
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2006
Last Update Date : 09/17/2012

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Directions to “ MRS. JANE ALICE YOUNG MSW” Practice Location

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