Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0063173 | TN |
NPI | 1053938076 |
---|---|
Provider Name | Ashley Young |
First Address | Murfreesboro, TN 37128-2995 |
Second Address | Murfreesboro, TN 37128-2995 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2020 |
Last Update Date | 26/06/2020 |