Provider Demographics
NPI:1386334415
Name:YOUNG, CHLOE YVONNE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:YVONNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-1422
Mailing Address - Country:US
Mailing Address - Phone:937-726-0573
Mailing Address - Fax:
Practice Address - Street 1:740 FERN CT
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-1265
Practice Address - Country:US
Practice Address - Phone:937-726-0573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant