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General NPI Number Information
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NPI Number | 1144055229
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Entity Type | Individual
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Provider Name | BAILEY M YOUNG LSW
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Gender | Female
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Dates
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Enumeration Date | 09/06/2024
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 222 MARION AVE
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City | MANSFIELD
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State | OH
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Zip | 44903-2138
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Country | US
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Telephone | 567-560-3582
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 PAVONIA RD
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City | MANSFIELD
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State | OH
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Zip | 44903-9778
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Country | US
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Telephone | 419-905-4801
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2411269
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License Number State | OH
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