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Individual

TIMOTHY DEWAYNE YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1317 E WALLACE ST, SHAWNEE, OK 74801-6412
(405) 243-3798
Mailing address
1317 E. WALLACE ST., SHAWNEE, OK 74801-6412
(405) 243-3798

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
OK

Other

Enumeration date
11/09/2011
Last updated
11/09/2011
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