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Organization

SUSAN N YOUNG INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUSAN N YOUNG PSY. D. (OWNER)
(904) 223-6414
Entity
Organization

Contact information

Practice address
13400 SUTTON PARK DR S, SUITE 1504, JACKSONVILLE, FL 32224-0236
(904) 223-6414
(904) 223-6418
Mailing address
13400 SUTTON PARK DR S, SUITE 1504, JACKSONVILLE, FL 32224-0236
(904) 223-6414
(904) 223-6418

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY7306
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AF756
MEDICARE PTAN
FL
Enumeration date
06/15/2007
Last updated
10/17/2011
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