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Individual

MR. GREGORY ALLEN YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
1411 PRINCESS ANNE STREET, FREDERICKSBURG, VA 22401
(304) 951-0250
Mailing address
4678 BONNEVILLE LN, WOODBRIDGE, VA 22193-3131
(304) 951-0250

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106S00000X
VA
Enumeration date
04/06/2018
Last updated
04/06/2018
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