Healthcare Provider Details

I. General information

NPI: 1518880228
Provider Name (Legal Business Name): KRISTEN ANN YOUNG PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13215 N 94TH DR
PEORIA AZ
85381-4838
US

IV. Provider business mailing address

13215 N 94TH DR
PEORIA AZ
85381-4838
US

V. Phone/Fax

Practice location:
  • Phone: 623-933-7722
  • Fax:
Mailing address:
  • Phone: 623-933-7722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number033362
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: