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General NPI Number Information
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NPI Number | 1497596506
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Entity Type | Individual
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Provider Name | LILLIAN YOUNG
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 2464 FORTUNE DR STE 195
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City | LEXINGTON
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State | KY
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Zip | 40509-4261
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Country | US
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Telephone | 859-899-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 120 E MAIN ST APT 1908
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City | LEXINGTON
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State | KY
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Zip | 40507-1346
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Country | US
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Telephone |
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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 | RBT-24-350164
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License Number State | KY
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