Provider Information for 1215177704
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Ms. SANDEE K YOUNG LCSW
Sex: Female
NPI: 1215177704
Last Updated: 2023-10-23
Certification Date: 2023-10-23
Certification Date: 2023-10-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215177704 | ||||||||
| Enumeration Date | 2009-02-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 34 LOUELLA ST BLACKFOOT, ID 83221-1609 United States Phone: 208-782-1322 | Fax:208-782-1322 | ||||||||
| Primary Practice Address | 34 LOUELLA ST BLACKFOOT, ID 83221-1609 United States Phone: 208-782-1322 | Fax:208-782-1322 | ||||||||
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