Provider Demographics
NPI:1043356421
Name:YOUNG, MARIA GABRIELLE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:GABRIELLE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 AIRPORT ROAD
Mailing Address - Street 2:#114
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541
Mailing Address - Country:US
Mailing Address - Phone:850-832-2462
Mailing Address - Fax:
Practice Address - Street 1:1014 AIRPORT RD # 114
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2884
Practice Address - Country:US
Practice Address - Phone:850-832-2462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical