Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PS016162 | PA |
NPI | 1033630116 |
---|---|
Provider Name | Jami F Young |
First Address | Philadelphia, PA 19103-6510 |
Second Address | Philadelphia, PA 19146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2017 |
Last Update Date | 29/06/2017 |