Provider Information for 1295562882
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REBECCA ANN YOUNG LPC
Other Names:Former Name:REBECCA ANN LOGSDONSex: Female
NPI: 1295562882
Last Updated: 2024-09-17
Certification Date: 2024-09-17
Certification Date: 2024-09-17
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1295562882 | ||||||||
| Enumeration Date | 2024-09-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4384 GRANT AVE LOVELAND, CO 80538-1719 United States Phone: 904-613-0443 | Fax: | ||||||||
| Primary Practice Address | 2360 E PERSHING BLVD CHEYENNE, WY 82001-5356 United States Phone: 307-778-7349 | Fax: | ||||||||
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