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Individual
MR. JEFFERSON DAVIS YOUNG JR.
Active
Individual
MR. JEFFERSON DAVIS YOUNG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP LCMFT LMLP
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LCP234
KS
103T00000X
Psychologist
Primary
LMLP0161
KS
106H00000X
Marriage & Family Therapist
LCMFT121
KS
Other
Enumeration date
01/17/2007
Last updated
04/03/2013
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