Provider Demographics
NPI:1710230735
Name:YOUNG, EMILY DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:DANIELLE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:COZAD
Mailing Address - State:NE
Mailing Address - Zip Code:69130-2114
Mailing Address - Country:US
Mailing Address - Phone:402-806-0557
Mailing Address - Fax:
Practice Address - Street 1:303 EAST 12TH STREET
Practice Address - Street 2:
Practice Address - City:COZAD
Practice Address - State:NE
Practice Address - Zip Code:69130
Practice Address - Country:US
Practice Address - Phone:308-784-2231
Practice Address - Fax:308-784-3449
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3109225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist