Healthcare Provider Details

I. General information

NPI: 1093980930
Provider Name (Legal Business Name): REBECCA MARGARITA YOUNG PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 W NORTHERN LIGHTS BLVD STE 1110
ANCHORAGE AK
99503-3985
US

IV. Provider business mailing address

188 W NORTHERN LIGHTS BLVD STE 1110
ANCHORAGE AK
99503-3985
US

V. Phone/Fax

Practice location:
  • Phone: 907-931-4309
  • Fax:
Mailing address:
  • Phone: 907-931-4309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number242434
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: