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General NPI Number Information
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NPI Number | 1467042705
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Entity Type | Individual
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Provider Name | KRISTIN KARAE' YOUNG
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Gender | Female
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 196 W GA HIGHWAY 49 APT F2
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-5142
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Country | US
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Telephone | 404-610-6551
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Fax |
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Provider Business Mailing Address
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Address Line | 320 REMINGTON DR
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City | COLUMBIA
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State | SC
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Zip | 29223-5315
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Country | US
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Telephone | 404-610-6551
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC006800
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License Number State | GA
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