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General NPI Number Information
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NPI Number | 1942192786
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Entity Type | Individual
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Provider Name | HALEY YOUNG
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Gender | Female
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 75 HIGHWAY 62 412 STE L
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City | ASH FLAT
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State | AR
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Zip | 72513-9629
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Country | US
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Telephone | 870-243-6292
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Fax |
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Provider Business Mailing Address
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Address Line | 550 HILLTOP DR
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City | BLACK ROCK
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State | AR
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Zip | 72415-9030
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Country | US
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Telephone | 870-759-0227
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5052
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License Number State | AR
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