Provider Demographics
NPI:1386862647
Name:YOUNG, KATHLEEN MARIE (ND)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MARIE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:KONTOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:8455 RAIN DANCE CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4987
Mailing Address - Country:US
Mailing Address - Phone:719-238-6816
Mailing Address - Fax:
Practice Address - Street 1:108 E SAINT VRAIN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1117
Practice Address - Country:US
Practice Address - Phone:719-238-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1442175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath