Healthcare Provider Details

I. General information

NPI: 1265056261
Provider Name (Legal Business Name): ZARRIA YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 E 32ND ST STE 121
TULSA OK
74135-5454
US

IV. Provider business mailing address

37140 BRYNFORD DR APT 201
CLINTON TOWNSHIP MI
48036-2457
US

V. Phone/Fax

Practice location:
  • Phone: 918-932-8774
  • Fax:
Mailing address:
  • Phone: 918-863-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: