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General NPI Number Information
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NPI Number | 1588577084
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Entity Type | Individual
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Provider Name | KENDALL ELIZABETH YOUNG
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Gender | Female
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 624 HAWKINS AVE
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City | RONKONKOMA
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State | NY
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Zip | 11779-2375
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Country | US
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Telephone | 631-240-3579
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Fax |
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Provider Business Mailing Address
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Address Line | 85 WOODVIEW LN
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City | CENTEREACH
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State | NY
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Zip | 11720-4073
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Country | US
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Telephone | 631-480-4904
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 2097423261
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License Number State | NY
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