Organization
SALLY S. YOUNG PHD, PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLY SERRELL YOUNG PHD (LICENSED PSYCHOLOGIST - DOCTORATE)
(802) 862-2773
Entity
Organization
Contact information
Practice address
86 LAKE ST, OFFICE 307, BURLINGTON, VT 05401-5297
(802) 862-2773
(802) 862-6496
Mailing address
PO BOX 626, BURLINGTON, VT 05402-0626
(802) 862-2773
(802) 862-6496
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
480000178
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008363
PTAN
VT
05
—
VT6583
—
VT
Enumeration date
10/20/2006
Last updated
03/07/2011
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