Provider Demographics
NPI:1275613812
Name:YOUNG, PATRICIA EILEEN (RD)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:EILEEN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6786 ROYAL OAK DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-5300
Mailing Address - Country:US
Mailing Address - Phone:540-774-4883
Mailing Address - Fax:540-774-4885
Practice Address - Street 1:4800 PLEASANT HILL DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3451
Practice Address - Country:US
Practice Address - Phone:540-774-4883
Practice Address - Fax:540-774-4885
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered