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NPI Code Detail

MEDICARE: ERICA ROXANNA YOUNG B.A,

MEDICARE: ERICA ROXANNA YOUNG B.A,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2106S00000XBehavior TechnicianWA

General Provider Information

NPI Number : 1083843981
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA ROXANNA YOUNG B.A,
Provider Business Mailing Address
First Line : 8605 HIPKINS RD SW APT 34
Second Line :
City : LAKEWOOD
State : WA
Zip : 98498-4677
Country : US
Telephone Number : 360-402-4999
Fax Number :
Provider Business Practice Location Address
First Line : 8725 S 212TH ST
Second Line :
City : KENT
State : WA
Zip : 98031-1921
Country : US
Telephone Number : 425-658-3016
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2009
Last Update Date : 06/26/2023

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Directions to “ ERICA ROXANNA YOUNG B.A,” Practice Location

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