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NPI Code Detail

MEDICARE: MS. BREONNA JANEA YOUNG

MEDICARE:  MS. BREONNA JANEA 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
1225C00000XRehabilitation Counselor

General Provider Information

NPI Number : 1922411180
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BREONNA JANEA YOUNG
Provider Business Mailing Address
First Line : 4523 COOL VALLEY DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-2351
Country : US
Telephone Number : 702-690-0785
Fax Number :
Provider Business Practice Location Address
First Line : 3050 W CHEYENNE AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-6025
Country : US
Telephone Number : 702-570-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 06/05/2014

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Directions to “ MS. BREONNA JANEA YOUNG ” Practice Location

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