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NPI Code Detail

MEDICARE: RHEA YOUNG LAC

MEDICARE: RHEA YOUNG LAC
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
1101YP2500XProfessional Counselor19380AZ

General Provider Information

NPI Number : 1558074484
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHEA YOUNG LAC
Provider Business Mailing Address
First Line : 8865 E BASELINE RD # 450
Second Line :
City : MESA
State : AZ
Zip : 85209-5300
Country : US
Telephone Number : 303-596-1156
Fax Number :
Provider Business Practice Location Address
First Line : 3512 N HIGLEY RD
Second Line :
City : MESA
State : AZ
Zip : 85215-9713
Country : US
Telephone Number : 602-449-7999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2023
Last Update Date : 01/05/2023

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Directions to “ RHEA YOUNG LAC” Practice Location

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