Provider Demographics
NPI:1407032535
Name:YOUNG, PAMELA DONIELL (LGSW)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:DONIELL
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 DOWNEY OAK CIR
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:DE
Mailing Address - Zip Code:19934-2200
Mailing Address - Country:US
Mailing Address - Phone:302-241-5016
Mailing Address - Fax:
Practice Address - Street 1:71 DOWNEY OAK CIR
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:DE
Practice Address - Zip Code:19934-2200
Practice Address - Country:US
Practice Address - Phone:302-241-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG13118104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker