Healthcare Provider Details

I. General information

NPI: 1760903108
Provider Name (Legal Business Name): RACHEL LEAH YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 GOODMAN AVE REAR 1
CINCINNATI OH
45239-4817
US

IV. Provider business mailing address

1803 GOODMAN AVE REAR 1
CINCINNATI OH
45239-4817
US

V. Phone/Fax

Practice location:
  • Phone: 513-462-9314
  • Fax:
Mailing address:
  • Phone: 513-462-9314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberSN190231
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: