Provider Demographics
NPI:1588499529
Name:YOUNG, HALEE (LMT)
Entity type:Individual
Prefix:
First Name:HALEE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6771 COYOTE CALL TRL
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-3757
Mailing Address - Country:US
Mailing Address - Phone:530-917-8092
Mailing Address - Fax:
Practice Address - Street 1:1001 PYRAMID WAY STE 402C
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4430
Practice Address - Country:US
Practice Address - Phone:530-917-8092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11253225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist