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NPI Code Detail

MEDICARE: JAKAYLA YOUNG

MEDICARE: JAKAYLA 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1700754975
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAKAYLA YOUNG
Provider Business Mailing Address
First Line : 5221 6TH STREET FRONTAGE RD E
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-5190
Country : US
Telephone Number : 217-381-0604
Fax Number :
Provider Business Practice Location Address
First Line : 5221 6TH STREET FRONTAGE RD E
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-5190
Country : US
Telephone Number : 217-292-1983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2025
Last Update Date : 02/09/2026

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Directions to “ JAKAYLA YOUNG ” Practice Location

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