Provider Demographics
NPI:1952175655
Name:YOUNGER, TIANE CHERELL
Entity Type:Individual
Prefix:MS
First Name:TIANE
Middle Name:CHERELL
Last Name:YOUNGER
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 1:3401 E WEST HWY APT 145
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1981
Mailing Address - Country:US
Mailing Address - Phone:917-773-2811
Mailing Address - Fax:
Practice Address - Street 1:1638 F ST NE APT 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4568
Practice Address - Country:US
Practice Address - Phone:917-773-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant