Healthcare Provider Details

I. General information

NPI: 1649187048
Provider Name (Legal Business Name): AMAYA C YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 24TH AVE NW STE 110
NORMAN OK
73069-6556
US

IV. Provider business mailing address

3301 12TH AVE SE APT 2526A
NORMAN OK
73072-7815
US

V. Phone/Fax

Practice location:
  • Phone: 405-467-3250
  • Fax:
Mailing address:
  • Phone: 972-750-8635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: