Individual
SHELBY RAE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 498-3091
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 498-3091
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704411728
MI
Other
Enumeration date
08/26/2019
Last updated
04/16/2024
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