Provider Demographics
NPI:1912798448
Name:YOUNG, ADAM LEE (OTR/L MS)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:LEE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:OTR/L MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6715 GUNSTON LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9432
Mailing Address - Country:US
Mailing Address - Phone:502-468-4154
Mailing Address - Fax:
Practice Address - Street 1:900 GAGEL AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4012
Practice Address - Country:US
Practice Address - Phone:502-368-5827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY161468225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation