Provider Demographics
NPI:1366493843
Name:YOUNG, ELIZABETH FREDERICK (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:FREDERICK
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N GLEBE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3558
Mailing Address - Country:US
Mailing Address - Phone:703-469-3971
Mailing Address - Fax:
Practice Address - Street 1:2501 N GLEBE RD STE 201
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-3558
Practice Address - Country:US
Practice Address - Phone:703-469-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003507225100000X
DCPT870662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist