Provider Demographics
NPI:1144699117
Name:YOUNG, VALERIE MARY (PHD, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MARY
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHD, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 MONTGOMERY RD STE 224
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3260
Mailing Address - Country:US
Mailing Address - Phone:513-991-7117
Mailing Address - Fax:513-257-2409
Practice Address - Street 1:10700 MONTGOMERY RD STE 224
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-3260
Practice Address - Country:US
Practice Address - Phone:513-991-7117
Practice Address - Fax:513-991-7117
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.5802133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered