Individual
MRS. AUDREY M YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN, CDE
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
901
MA
133VN1004X
Pediatric Nutrition Registered Dietitian
901
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00376201
MEDICARE PTAN
MA
Enumeration date
05/01/2007
Last updated
12/22/2022
Update your record
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