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Individual

NIKKI L YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
511 PERRY ST, DEFIANCE, OH 43512-2123
(419) 428-3800
(419) 784-2523
Mailing address
511 PERRY ST, DEFIANCE, OH 43512-2123
(419) 428-3800
(419) 784-2523

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CDCA.162513
LICENSE
OH
01
W.1600067
LICENSE
OH
Enumeration date
12/07/2017
Last updated
12/07/2017
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