Individual
MISS CICEL RENEE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2620 W CUSTER AVE, 4, GLENDALE, WI 53209-4982
(770) 895-5355
Mailing address
2626 WEST CUSTER AVE # 4, GLENDALE, WI 53209
(770) 895-5355
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313244031
WI
Other
Enumeration date
05/31/2011
Last updated
05/31/2011
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