Provider Demographics
NPI:1003010281
Name:YOUNG, DENISE ANN (BS MUSIC THERAPY)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:BS MUSIC THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18052 BENETA WAY
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2602
Mailing Address - Country:US
Mailing Address - Phone:714-392-1077
Mailing Address - Fax:
Practice Address - Street 1:18052 BENETA WAY
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2602
Practice Address - Country:US
Practice Address - Phone:714-392-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist