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Individual
NICHOLAS DAVID YOUNG
Active
Individual
NICHOLAS DAVID YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3501-57
WI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3501
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659700508
—
WI
Enumeration date
11/01/2013
Last updated
07/21/2022
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