Individual
ELIZABETH YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 MAPLE ST, SPRINGFIELD, MA 01103-2203
(413) 846-0445
Mailing address
120 MAPLE ST, SPRINGFIELD, MA 01103-2203
(413) 846-0445
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295
—
MA
05
—
1307576
—
MA
01
—
M18463
BLUE CROSS/BLUE SHIELD
—
Enumeration date
04/14/2011
Last updated
04/14/2011
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