Individual
DR. PETER BERNHART YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
10820 KINGSTON PIKE, SUITE 21, KNOXVILLE, TN 37934-3066
(865) 671-6935
(865) 675-0502
Mailing address
10820 KINGSTON PIKE, SUITE 21, KNOXVILLE, TN 37934-3066
(865) 671-6935
(865) 675-0502
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
718
WV
103G00000X
Clinical Neuropsychologist
Primary
P-1466
TN
103TC0700X
Clinical Psychologist
718
WV
103TC0700X
Clinical Psychologist
P-1466
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007179
BLUECROSSBLUESHIELD
TN
05
—
3684340
—
TN
01
—
718
PSYCHOLOGY LICENSE #
WV
01
—
P-1466
PSYCHOLOGY LICENSE #
TN
Enumeration date
05/16/2006
Last updated
10/13/2010
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