Provider Demographics
NPI:1104127562
Name:RABINE-YOUNG, DAVID JAMES (MSSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:RABINE-YOUNG
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-2249
Mailing Address - Country:US
Mailing Address - Phone:507-334-3992
Mailing Address - Fax:
Practice Address - Street 1:2504 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-2249
Practice Address - Country:US
Practice Address - Phone:507-334-3992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical