Provider Demographics
NPI:1902683725
Name:YOUNG, ALIAH JOI
Entity Type:Individual
Prefix:
First Name:ALIAH
Middle Name:JOI
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 1:100 E SYBELIA AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4773
Mailing Address - Country:US
Mailing Address - Phone:786-873-9472
Mailing Address - Fax:
Practice Address - Street 1:100 E SYBELIA AVE STE 150
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4773
Practice Address - Country:US
Practice Address - Phone:407-986-7442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist