Provider Demographics
NPI:1386086932
Name:YOUNG, BEVERLY J (ATC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:YOUNG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12705 GLADYS RETREAT CIR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3336
Mailing Address - Country:US
Mailing Address - Phone:330-518-5492
Mailing Address - Fax:
Practice Address - Street 1:600 22ND ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20052-0055
Practice Address - Country:US
Practice Address - Phone:202-994-3557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer