Provider Demographics
NPI:1184346439
Name:YOUNG, HOPE MELTON (ATC)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:MELTON
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 1:3194 HOLLIS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-5932
Mailing Address - Country:US
Mailing Address - Phone:615-904-4595
Mailing Address - Fax:
Practice Address - Street 1:3194 HOLLIS CREEK RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-5932
Practice Address - Country:US
Practice Address - Phone:615-904-4595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2000005978OtherBOC PROVIDER NUMBER
TN1639OtherSTATE NUMBER