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NPI 1043421563

NPI 1043421563 : MARIELLA M YOUNG DC : ROCKVILLE, MD

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General NPI Number Information
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    NPI Number           |    1043421563
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    Entity Type          |    Individual 
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    Provider Name        |    MARIELLA M YOUNG DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/25/2007
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    Last Update Date     |    03/03/2008
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Provider Practice Location Address
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    Address Line         |    6137 EXECUTIVE BLVD 
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    City                 |    ROCKVILLE
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    State                |    MD
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    Zip                  |    20852-3901
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    Country              |    US
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    Telephone            |    301-770-9601
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    Fax                  |    301-770-9540
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Provider Business Mailing Address
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    Address Line         |    6137 EXECUTIVE BLVD 
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    City                 |    ROCKVILLE
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    State                |    MD
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    Zip                  |    20852-3901
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    Country              |    US
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    Telephone            |    301-770-9601
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    Fax                  |    301-770-9540
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    01979
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    0104555714
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    License Number State |    VA
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Taxonomy #3
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    Taxonomy Code        |    111NN0400X
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    Taxonomy Name        |    Neurology Chiropractor
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    License Number       |    01979
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    License Number State |    MD
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Taxonomy #4
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    Taxonomy Code        |    111NN0400X
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    Taxonomy Name        |    Neurology Chiropractor
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    License Number       |    0104555714
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    License Number State |    VA
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Taxonomy #5
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    Taxonomy Code        |    111NR0400X
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    Taxonomy Name        |    Rehabilitation Chiropractor
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    License Number       |    01979
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    License Number State |    MD
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Taxonomy #6
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    Taxonomy Code        |    111NR0400X
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    Taxonomy Name        |    Rehabilitation Chiropractor
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    License Number       |    0104555714
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    License Number State |    VA
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Taxonomy #7
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    Taxonomy Code        |    111NS0005X
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    Taxonomy Name        |    Sports Physician Chiropractor
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    License Number       |    01979
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    License Number State |    MD
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Taxonomy #8
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    Taxonomy Code        |    111NS0005X
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    Taxonomy Name        |    Sports Physician Chiropractor
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    License Number       |    0104555714
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    License Number State |    VA
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Taxonomy #9
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    Taxonomy Code        |    111NX0100X
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    Taxonomy Name        |    Occupational Health Chiropractor
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    License Number       |    01979
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    License Number State |    MD
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Taxonomy #10
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    Taxonomy Code        |    111NX0100X
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    Taxonomy Name        |    Occupational Health Chiropractor
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    License Number       |    0104555714
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    License Number State |    VA
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Taxonomy #11
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    Taxonomy Code        |    111NX0800X
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    Taxonomy Name        |    Orthopedic Chiropractor
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    License Number       |    01979
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    License Number State |    MD
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Taxonomy #12
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    Taxonomy Code        |    111NX0800X
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    Taxonomy Name        |    Orthopedic Chiropractor
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    License Number       |    0104555714
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    License Number State |    VA
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