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NPI Code Detail

MEDICARE: ROSS YOUNG

MEDICARE: ROSS YOUNG
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1598219859
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSS YOUNG
Provider Business Mailing Address
First Line : 21712 FRAZHO ST
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48081-2852
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19992 KELLY RD
Second Line :
City : HARPER WOODS
State : MI
Zip : 48225-1919
Country : US
Telephone Number : 855-772-8847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2016
Last Update Date : 07/27/2025

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Directions to “ ROSS YOUNG ” Practice Location

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