Individual
TIMOTHY LEE DEYOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
2600 FERNBROOK LN N STE 138, PLYMOUTH, MN 55447-4752
(952) 544-0349
Mailing address
3526 GRIMES AVE N, ROBBINSDALE, MN 55422-2838
(218) 252-2448
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10295
MN
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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