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General NPI Number Information
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NPI Number | 1497520134
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Entity Type | Individual
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Provider Name | MS. TERRI YOUNG
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Gender | Female
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 1841 N PERRY ST
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City | PONTIAC
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State | MI
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Zip | 48340-2235
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Country | US
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Telephone | 947-957-4670
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Fax |
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Provider Business Mailing Address
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Address Line | 21631 WHITMORE ST
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City | OAK PARK
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State | MI
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Zip | 48237-2614
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Country | US
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Telephone | 248-602-6366
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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