Individual
MS. KIM KORY YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.HTECHICIAN/L.L.MSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1-04781
MI
175T00000X
Peer Specialist
—
MI
175T00000X
Peer Specialist
—
—
247200000X
Other Technician
Primary
L148347
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L148347
DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF HEALTH CARE SERVICES
MI
Enumeration date
09/01/2016
Last updated
04/10/2020
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