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NPI 1992338115

NPI 1992338115 : BRIANA NICOLE YOUNG DPT : MC LEAN, VA

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General NPI Number Information
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    NPI Number           |    1992338115
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    Entity Type          |    Individual 
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    Provider Name        |    BRIANA NICOLE YOUNG DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/17/2020
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    Last Update Date     |    02/17/2020
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Provider Practice Location Address
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    Address Line         |    6862 ELM ST STE 105 
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    City                 |    MC LEAN
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    State                |    VA
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    Zip                  |    22101-3862
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    Country              |    US
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    Telephone            |    703-556-7788
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    Fax                  |    703-556-9750
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Provider Business Mailing Address
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    Address Line         |    1201 S EADS ST APT 1407 
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    City                 |    ARLINGTON
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    State                |    VA
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    Zip                  |    22202-2843
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    Country              |    US
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    Telephone            |    520-269-3387
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    2305213428
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    License Number State |    VA
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