Healthcare Provider Details

I. General information

NPI: 1528603149
Provider Name (Legal Business Name): KATHRYN MARIE YEE-YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 W HARRIS AVE
SAN ANGELO TX
76903-6392
US

IV. Provider business mailing address

439 W HARRIS AVE
SAN ANGELO TX
76903-6392
US

V. Phone/Fax

Practice location:
  • Phone: 325-993-9265
  • Fax:
Mailing address:
  • Phone: 325-993-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: