Individual
MRS. DERANDORIA ANN YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
280 1ST ST, BLDG 17, HOLLOMAN AFB, NM 88330-8273
(575) 572-7061
Mailing address
280 FIRST STREET, BLDG 17, HOLLOMAN AFB, NM 88330
(575) 572-7061
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-507
WY
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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