Provider Demographics
NPI:1558166629
Name:YOUNGER, SHAYLEA
Entity type:Individual
Prefix:
First Name:SHAYLEA
Middle Name:
Last Name:YOUNGER
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:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:AK
Mailing Address - Zip Code:99674-0333
Mailing Address - Country:US
Mailing Address - Phone:907-795-8435
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 333
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-0333
Practice Address - Country:US
Practice Address - Phone:907-206-4401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician