Provider Demographics
NPI:1578879649
Name:YOUNG, KATHRYN C (MS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E CAMPHOR AVE
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-2819
Mailing Address - Country:US
Mailing Address - Phone:251-972-8251
Mailing Address - Fax:251-943-2144
Practice Address - Street 1:201 E CAMPHOR AVE
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2819
Practice Address - Country:US
Practice Address - Phone:251-972-8251
Practice Address - Fax:251-943-2144
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health