Provider Demographics
NPI:1326929415
Name:YOUNG, SAMANTHA BROOKE
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:BROOKE
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 1:937 VINE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:WV
Mailing Address - Zip Code:25266-9263
Mailing Address - Country:US
Mailing Address - Phone:407-842-0442
Mailing Address - Fax:
Practice Address - Street 1:937 VINE RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:WV
Practice Address - Zip Code:25266-9263
Practice Address - Country:US
Practice Address - Phone:407-842-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant