Provider Demographics
NPI:1780209155
Name:YOUNG, ROBBICCAA (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ROBBICCAA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S EASTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRANCH
Mailing Address - State:IN
Mailing Address - Zip Code:47648-1402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 W MAIN ST
Practice Address - Street 2:
Practice Address - City:POSEYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47633
Practice Address - Country:US
Practice Address - Phone:812-270-4405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer