Provider Demographics
NPI:1376962886
Name:YOUNG, ROSALINDA
Entity Type:Individual
Prefix:MRS
First Name:ROSALINDA
Middle Name:
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 1:801 RIPPERTON RUN
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-1657
Mailing Address - Country:US
Mailing Address - Phone:512-219-6447
Mailing Address - Fax:
Practice Address - Street 1:13642 N HWY 183 BLDG 2A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2265
Practice Address - Country:US
Practice Address - Phone:512-331-4115
Practice Address - Fax:512-331-8176
Is Sole Proprietor?:No
Enumeration Date:2014-04-11
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104374225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist