Provider Demographics
NPI:1154089845
Name:YOUNG, BRITTANY JULIE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JULIE
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 1:540 BLUE SHUTTERS RD
Mailing Address - Street 2:
Mailing Address - City:ROARING BROOK TWP
Mailing Address - State:PA
Mailing Address - Zip Code:18444-7621
Mailing Address - Country:US
Mailing Address - Phone:570-764-0300
Mailing Address - Fax:
Practice Address - Street 1:1003 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-4002
Practice Address - Country:US
Practice Address - Phone:570-764-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABACB460932103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst