Provider Demographics
NPI:1821202979
Name:YOUNG, WENDY HAMILTON (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:HAMILTON
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14526 SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40468-9740
Mailing Address - Country:US
Mailing Address - Phone:859-332-8852
Mailing Address - Fax:
Practice Address - Street 1:3010 TAYLOR SPRINGS DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1506
Practice Address - Country:US
Practice Address - Phone:800-399-8224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY887749133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered