Individual
MRS. JENNIFER YOUNGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12642 CHAPEL RD, CLIFTON, VA 20124-1953
(571) 563-8976
Mailing address
11818 CLARA WAY, FAIRFAX STATION, VA 22039-1104
(703) 898-3049
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305006688
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196835
ANTHEM
VA
01
—
2130582
MAMSI
—
01
—
7727306
AETNA
—
Enumeration date
06/06/2007
Last updated
12/26/2023
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