Healthcare Provider Details

I. General information

NPI: 1093431447
Provider Name (Legal Business Name): LYNDSEY YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10164 FORD AVE STE D
RICHMOND HILL GA
31324-3948
US

IV. Provider business mailing address

10164 FORD AVE STE D
RICHMOND HILL GA
31324-3948
US

V. Phone/Fax

Practice location:
  • Phone: 912-459-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA003286
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: