Individual
CHRISTOPHER JON YOUNGBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT, PHD
Contact information
Practice address
2250 FIELDSTONE DR, AMMON, ID 83401-5880
(208) 552-3251
Mailing address
2250 FIELDSTONE DR, AMMON, ID 83401-5880
(208) 552-3251
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT2860
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010145467
REGENCE BLUE SHIELD OF ID
ID
Enumeration date
10/02/2006
Last updated
12/15/2014
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