Provider Demographics
NPI:1154748135
Name:YOUNG, JOANN (MED, BCBA)
Entity type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15417 STAKED PLAINS LOOP
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4852
Mailing Address - Country:US
Mailing Address - Phone:512-705-4721
Mailing Address - Fax:
Practice Address - Street 1:15417 STAKED PLAINS LOOP
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-4852
Practice Address - Country:US
Practice Address - Phone:512-705-4721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst