Provider Demographics
NPI:1811171242
Name:YOUNG, ANGELA SUE (AAS)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SUE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:AAS
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:SUE
Other - Last Name:ARBOGAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AAS
Mailing Address - Street 1:5907 73RD AVENUE CT W
Mailing Address - Street 2:APT. #206
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-4705
Mailing Address - Country:US
Mailing Address - Phone:253-212-3880
Mailing Address - Fax:
Practice Address - Street 1:5907 73RD AVENUE CT W
Practice Address - Street 2:APT. #206
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-4705
Practice Address - Country:US
Practice Address - Phone:253-212-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00058859101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health