MEDICARE: DIANA YOUNG

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
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1164658605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA YOUNG

Provider Business Mailing Address
First Line	:	1155 PRESSLER ST
Second Line	:	CPB5.3535 - UNIT 1354
City	:	HOUSTON
State	:	TX
Zip	:	77030-3721
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 PRESSLER ST
Second Line	:	CPB5.3535 - UNIT 1354
City	:	HOUSTON
State	:	TX
Zip	:	77030-3721
Country	:	US
Telephone Number	:	713-745-5371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2009
Last Update Date	:	06/10/2009

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Directions to “ DIANA YOUNG ” Practice Location

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