Provider Demographics
NPI:1114191491
Name:DEYOUNG, KRISTEN LYNNE
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LYNNE
Last Name:DEYOUNG
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 1:14201 SCHOOL LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-2866
Mailing Address - Country:US
Mailing Address - Phone:808-244-1467
Mailing Address - Fax:808-242-4762
Practice Address - Street 1:14201 SCHOOL LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-2866
Practice Address - Country:US
Practice Address - Phone:301-952-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist