Provider Demographics
NPI:1326898297
Name:YOUNG, SCHEREEN ANN (LMT)
Entity Type:Individual
Prefix:MS
First Name:SCHEREEN
Middle Name:ANN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:SCHEREEN
Other - Middle Name:ANN
Other - Last Name:DOUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 FLORIDA PARK DR. N.
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137
Mailing Address - Country:US
Mailing Address - Phone:386-569-9663
Mailing Address - Fax:
Practice Address - Street 1:25 FLORIDA PARK DR. N.
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137
Practice Address - Country:US
Practice Address - Phone:386-569-9663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA79776225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDH11089Medicaid