Healthcare Provider Details

I. General information

NPI: 1023057718
Provider Name (Legal Business Name): BARBARA K. YOUNG M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E ALCOTT AVE
FERGUS FALLS MN
56537-2903
US

IV. Provider business mailing address

126 E ALCOTT AVE
FERGUS FALLS MN
56537-2903
US

V. Phone/Fax

Practice location:
  • Phone: 218-736-6987
  • Fax: 218-736-6980
Mailing address:
  • Phone: 218-736-6987
  • Fax: 218-736-6980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLICSW 7761
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: