Provider Demographics
NPI:1639330335
Name:YOUNG, LAUREN JEAN (ND)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JEAN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:JEAN
Other - Last Name:GOUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:PO BOX 8228
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040
Mailing Address - Country:US
Mailing Address - Phone:860-533-0179
Mailing Address - Fax:860-812-2025
Practice Address - Street 1:315 EAST CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040
Practice Address - Country:US
Practice Address - Phone:860-533-0179
Practice Address - Fax:860-812-2025
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000397175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath