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NPI Code Detail

MEDICARE: MRS. ROI ANGELIQ YOUNG CHILDRESS

MEDICARE: MRS. ROI ANGELIQ YOUNG CHILDRESS
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
1106S00000XBehavior TechnicianVA

General Provider Information

NPI Number : 1457153835
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROI ANGELIQ YOUNG CHILDRESS
Provider Business Mailing Address
First Line : 2545 ALLIE NICOLE CIR APT 301
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-7012
Country : US
Telephone Number : 757-752-4920
Fax Number :
Provider Business Practice Location Address
First Line : 3101 MAGIC HOLLOW BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23453-3010
Country : US
Telephone Number : 757-639-2218
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2025
Last Update Date : 01/13/2026

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