Provider Demographics
NPI:1003003989
Name:YOUNG, MICHELLE LOREEN
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LOREEN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W NYE LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1541
Mailing Address - Country:US
Mailing Address - Phone:775-884-9911
Mailing Address - Fax:775-884-9913
Practice Address - Street 1:680 W NYE LN
Practice Address - Street 2:SUITE 102
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-1541
Practice Address - Country:US
Practice Address - Phone:775-884-9911
Practice Address - Fax:775-884-9913
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker