MEDICARE: MRS. ALLISON COLLEEN YOUNG MS OTR/L

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	225X00000X	Occupational Therapist	OT 006532	OH

General Provider Information

NPI Number	:	1356519441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON COLLEEN YOUNG MS OTR/L

Provider Business Mailing Address
First Line	:	4759 COACHFORD DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-7334
Country	:	US
Telephone Number	:	614-378-9079
Fax Number	:	614-776-4037

Provider Business Practice Location Address
First Line	:	4759 COACHFORD DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-7334
Country	:	US
Telephone Number	:	614-378-9079
Fax Number	:

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

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	12/30/2014

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