Provider Information for 1992006431
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Mrs. TANYA Y YOUNG LPCC
Other Names:Former Name:TANYA Y GREAVES CSC-ADSex: Female
NPI: 1992006431
Last Updated: 2020-01-13
Certification Date: 2020-01-13
Certification Date: 2020-01-13
Details
Name | Value | ||||||||||||
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NPI | 1992006431 | ||||||||||||
Enumeration Date | 2010-11-16 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 6066 SHINGLE CREEK PKWY # 172 BROOKLYN CENTER, MN 55430-2316 United States Phone: 763-220-4971 | Fax: | ||||||||||||
Primary Practice Address | 6066 SHINGLE CREEK PKWY # 172 BROOKLYN CENTER, MN 55430-2316 United States Phone: 763-220-4971 | Fax: | ||||||||||||
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