Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 001266 | IA |
Y | 103T00000X | Psychologist | 001266 | IA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1356 | KS |
N | 103TC1900X | Counseling Psychologist | ||
N | 103TH0100X | Health Service | 000579 | IA |
NPI | 1033425731 |
---|---|
Provider Name | Scott Patrick Young |
First Address | Urbandale, IA 50322-4108 |
Second Address | Urbandale, IA 50322-4108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2010 |
Last Update Date | 16/02/2017 |