1174818652 NPI number — MRS. ADRIANA PINILLA YOUNG M.ED, BCBA

Table of content: MRS. ADRIANA PINILLA YOUNG M.ED, BCBA (NPI 1174818652)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174818652 NPI number — MRS. ADRIANA PINILLA YOUNG M.ED, BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YOUNG
Provider First Name:
ADRIANA
Provider Middle Name:
PINILLA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED, BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PINILLA
Provider Other First Name:
ADRIANA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174818652
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2009 WRENS NEST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH CHESTERFIELD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23235-3663
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-882-8881
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9201 ARBORETUM PKWY STE 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHESTERFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23236-5402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-912-1338
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1-09-5002 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)