Provider Demographics
NPI:1437964020
Name:YOUNG, TIERRA (RBT)
Entity type:Individual
Prefix:
First Name:TIERRA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 21ST ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1625
Mailing Address - Country:US
Mailing Address - Phone:856-676-8591
Mailing Address - Fax:
Practice Address - Street 1:6100 VETERANS PKWY STE 11
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3514
Practice Address - Country:US
Practice Address - Phone:067-221-8966
Practice Address - Fax:706-705-9791
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician