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General NPI Number Information
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NPI Number | 1437860749
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Entity Type | Individual
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Provider Name | LEIGHA YOUNG
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Gender | Female
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | N5650 BROAD ST
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City | SHIOCTON
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State | WI
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Zip | 54170-8626
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Country | US
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Telephone | 920-986-3351
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Fax |
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Provider Business Mailing Address
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Address Line | N5650 BROAD ST
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City | SHIOCTON
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State | WI
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Zip | 54170-8626
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Country | US
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Telephone | 920-986-3351
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 3001030014
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License Number State | WI
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