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General NPI Number Information
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NPI Number | 1992947428
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Entity Type | Individual
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Provider Name | CHERYL SPEIGHT YOUNG OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 05/09/2014
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Provider Practice Location Address
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Address Line | 4101 SOUTHPOINT DR E
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City | JACKSONVILLE
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State | FL
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Zip | 32216-0996
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Country | US
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Telephone | 904-296-6800
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Fax | 904-503-8196
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Provider Business Mailing Address
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Address Line | 9901 WINDWATER CT
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4110
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Country | US
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Telephone | 904-652-7859
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 13057
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License Number State | FL
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