Provider Demographics
NPI:1518664861
Name:YOUNG, KAY LAVETTE (HEALTH EDUCATOR)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:LAVETTE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:HEALTH EDUCATOR
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:LAVETTE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HEALTH EDUCATOR
Mailing Address - Street 1:105 SHADOWLANE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38635-3148
Mailing Address - Country:US
Mailing Address - Phone:662-544-6411
Mailing Address - Fax:
Practice Address - Street 1:105 SHADOWLANE DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:38635-3148
Practice Address - Country:US
Practice Address - Phone:662-544-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach