Young, Ethan

Young, Ethan is an individual health care provider with primary practice located at 8700 E 29Th St N , Wichita KS 67226-2169. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Young, Ethan can be contacted via phone (316) 634-8710.

Contact Information

Primary practice address
8700 E 29Th St N Wichita KS 67226-2169
Phone: (316) 634-8710
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1558818468
LBN Legal business name Young, Ethan
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2016
Last updated Apr 6th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558818468 NPPES
Kansas MEDICAID 201146730C

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