MEDICARE: MISS DEANNA MICHELE YOUNG

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	172A00000X	Driver	OH
2	3747P1801X	Personal Care Attendant	OH
3	376J00000X	Homemaker	OH
4	172A00000X	Driver

General Provider Information

NPI Number	:	1316647191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DEANNA MICHELE YOUNG

Provider Business Mailing Address
First Line	:	3461 COUNTY RD N
Second Line	:
City	:	MC CLURE
State	:	OH
Zip	:	43534-9748
Country	:	US
Telephone Number	:	419-438-0086
Fax Number	:

Provider Business Practice Location Address
First Line	:	3461 COUNTY RD N
Second Line	:
City	:	MC CLURE
State	:	OH
Zip	:	43534-9748
Country	:	US
Telephone Number	:	419-438-0086
Fax Number	:

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

Provider Enumeration Date	:	03/09/2023
Last Update Date	:	03/09/2023

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Directions to “ MISS DEANNA MICHELE YOUNG ” Practice Location

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