Provider Demographics
NPI:1598078875
Name:YOUNG, TENE
Entity Type:Individual
Prefix:
First Name:TENE
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 1:1912 JACKSON ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2434
Mailing Address - Country:US
Mailing Address - Phone:202-270-1693
Mailing Address - Fax:301-576-8677
Practice Address - Street 1:10707 ASTORIA DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-2140
Practice Address - Country:US
Practice Address - Phone:301-808-4901
Practice Address - Fax:301-576-8677
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation