Provider Demographics
NPI:1932428588
Name:YOUNG, DORIS
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 MT CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:HURLEYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12747-6016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:338 MT CLIFF RD
Practice Address - Street 2:
Practice Address - City:HURLEYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12747-6016
Practice Address - Country:US
Practice Address - Phone:845-794-8080
Practice Address - Fax:845-794-8343
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)