Healthcare Provider Details

I. General information

NPI: 1093285421
Provider Name (Legal Business Name): FRANCES ANNA YOUNG CSW INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 CASCADE VALLEY CT
LAS VEGAS NV
89128-0449
US

IV. Provider business mailing address

8316 MONICO VALLEY CT
LAS VEGAS NV
89128-2002
US

V. Phone/Fax

Practice location:
  • Phone: 702-240-8639
  • Fax: 702-240-6970
Mailing address:
  • Phone: 702-809-9247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number7633-S
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: