Provider Demographics
NPI:1972485126
Name:YOUNG, CAROL ANN
Entity type:Individual
Prefix:MISS
First Name:CAROL
Middle Name:ANN
Last Name:YOUNG
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 1:2423 S HOLLAND SYLVANIA RD APT 175
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1440
Mailing Address - Country:US
Mailing Address - Phone:419-309-0918
Mailing Address - Fax:419-309-0918
Practice Address - Street 1:5069 OTTERBEIN WAY
Practice Address - Street 2:
Practice Address - City:MONCLOVA
Practice Address - State:OH
Practice Address - Zip Code:43542-8500
Practice Address - Country:US
Practice Address - Phone:419-878-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA003313224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant