Provider Demographics
NPI:1114007192
Name:YOUNG, DONNA YVONNE
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:YVONNE
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 1:309 W CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5603
Mailing Address - Country:US
Mailing Address - Phone:580-234-2700
Mailing Address - Fax:580-234-4727
Practice Address - Street 1:309 W CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5603
Practice Address - Country:US
Practice Address - Phone:580-234-2700
Practice Address - Fax:580-234-4727
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health