Healthcare Provider Details

I. General information

NPI: 1598078875
Provider Name (Legal Business Name): TENE YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10707 ASTORIA DR
UPPER MARLBORO MD
20774-2140
US

IV. Provider business mailing address

1912 JACKSON ST NE
WASHINGTON DC
20018-2434
US

V. Phone/Fax

Practice location:
  • Phone: 301-808-4901
  • Fax: 301-576-8677
Mailing address:
  • Phone: 202-270-1693
  • Fax: 301-576-8677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: