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General NPI Number Information
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NPI Number | 1508221706
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Entity Type | Individual
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Provider Name | LATOYA YOUNG
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Gender | Female
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Dates
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Enumeration Date | 12/15/2015
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 13390 GREENVIEW DR APT 304
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City | SOUTHGATE
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State | MI
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Zip | 48195-3429
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Country | US
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Telephone | 734-245-7955
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Fax |
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Provider Business Mailing Address
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Address Line | 420 EUREKA RD # 344
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City | WYANDOTTE
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State | MI
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Zip | 48192-5842
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Country | US
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Telephone | 734-245-7955
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801098036
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License Number State | MI
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