Healthcare Provider Details

I. General information

NPI: 1093638306
Provider Name (Legal Business Name): KAITLYN YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 N KOLB RD STE B
TUCSON AZ
85710-1333
US

IV. Provider business mailing address

4138 E DESERT PL UNIT A
TUCSON AZ
85712-2400
US

V. Phone/Fax

Practice location:
  • Phone: 520-867-1660
  • Fax:
Mailing address:
  • Phone: 860-538-9861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-50921
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: