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General NPI Number Information
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NPI Number | 1871032714
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Entity Type | Individual
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Provider Name | MR. DALE YOUNG
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Gender | Male
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 10026 HOBART RD
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City | KIRTLAND
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State | OH
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Zip | 44094-9723
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Country | US
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Telephone | 216-283-4400
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Fax | 216-283-2099
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Provider Business Mailing Address
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Address Line | 10026 HOBART RD
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City | KIRTLAND
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State | OH
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Zip | 44094-9723
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Country | US
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Telephone | 216-283-4400
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Fax | 216-283-2099
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | I0007247
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License Number State | OH
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