Provider Demographics
NPI:1891222048
Name:YOUNG, DALANEY (IBCLC)
Entity Type:Individual
Prefix:
First Name:DALANEY
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CHESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7813
Mailing Address - Country:US
Mailing Address - Phone:720-234-3643
Mailing Address - Fax:
Practice Address - Street 1:13 CHESHIRE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7813
Practice Address - Country:US
Practice Address - Phone:720-234-3643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11214213174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
11214213OtherIBLCE