Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3047 | TN |
Y | 103TC0700X | Clinical Psychologist | 3047 | TN |
N | 103G00000X | Clinical Psychologist | 3047 | TN |
N | 103TC0700X | Clinical Psychologist | 3047 | TN |
N | 103TF0200X | Forensic Psychologist | 3047 | TN |
N | 103TH0100X | Health Service | 3047 | TN |
N | 103TR0400X | Rehabilitation Psychologist | 3047 | TN |
NPI | 1740541333 |
---|---|
Provider Name | John Christopher Young |
First Address | Chattanooga, TN 37403-1306 |
Second Address | Chattanooga, TN 37403-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2012 |
Last Update Date | 31/05/2012 |