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General NPI Number Information
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NPI Number | 1740199611
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Entity Type | Individual
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Provider Name | CHINA TATYANNA YOUNG
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Gender | Female
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 524 S HOUSTON LAKE RD BLDG J
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City | WARNER ROBINS
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State | GA
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Zip | 31088-9027
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Country | US
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Telephone | 478-777-5284
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Fax | 470-290-6429
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Provider Business Mailing Address
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Address Line | 104 SIG CT
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City | KATHLEEN
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State | GA
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Zip | 31047-1109
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC011397
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License Number State | GA
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