Young, Fanny Mariela
Young, Fanny Mariela is an sole proprietor health care provider with primary practice located at 300 Constitution Ave Apt 335 , Bayonne NJ 07002-5083. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Young, Fanny Mariela can be contacted via phone (908) 358-3939.Contact Information
Primary practice address
300 Constitution Ave Apt 335
Bayonne NJ 07002-5083
Phone: (908) 358-3939
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Behavioral Health & Social Service Providers / School | 1041S0200X | ||
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1053079194 |
|---|---|
| LBN Legal business name | Young, Fanny Mariela |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2021 |
| Last updated | Dec 6th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053079194 | NPPES |
| New Jersey | Other | Y68112597453792 | DRIVERS LICENSE |
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