MEDICARE: LAUREN WHITNEY YOUNGBORG

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.)	14165	TX

General Provider Information

NPI Number	:	1184061772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN WHITNEY YOUNGBORG

Provider Business Mailing Address
First Line	:	2211 W BRAKER LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-4031
Country	:	US
Telephone Number	:	512-334-2686
Fax Number	:	512-623-5290

Provider Business Practice Location Address
First Line	:	2211 W BRAKER LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-4031
Country	:	US
Telephone Number	:	512-334-2686
Fax Number	:	512-623-5290

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

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	05/23/2013

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Directions to “ LAUREN WHITNEY YOUNGBORG ” Practice Location

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