| Samantha Jane Young, | |
|
15590 90th St Ne, Otsego, MN 55330-9452 | |
| (763) 755-4275 | |
| (763) 755-4261 |
| Full Name | Samantha Jane Young |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Pediatrics |
| Location | 15590 90th St Ne, Otsego, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013787001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XP0200X | Occupational Therapist - Pediatrics | 6062 (Minnesota) | Primary |
| Provider Name | Family Speech & Therapy Services Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1235285966 PECOS PAC ID: 8022335397 Enrollment ID: O20150325001650 |
| Mailing Address | Practice Location Address |
|---|---|
| Samantha Jane Young, 1723 N 66th St, Superior, WI 54880-6043 Ph: () - | Samantha Jane Young, 15590 90th St Ne, Otsego, MN 55330-9452 Ph: (763) 755-4275 |
Melanie Deutsch, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-755-4275 Fax: 763-755-4261 | |
Katelyn Elizabeth O'keefe, M.S. OTR/L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 8540 Quaday Ave Ne, Otsego, MN 55330 Phone: 763-441-0298 | |
Deborah Gabel, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-755-4275 | |
Emily A Boughner, MS, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-755-4275 Fax: 763-755-4261 | |
Kyle Lee Cacho, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-755-4275 | |
Andrea Maureen Gredvig, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 8540 Quaday Ave Ne, Otsego, MN 55330 Phone: 763-441-0298 |