Healthcare Provider Details

I. General information

NPI: 1326316480
Provider Name (Legal Business Name): STEPHANIE A.Z. YOUNG PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 FULLER RD
ANN ARBOR MI
48105-2303
US

IV. Provider business mailing address

2215 FULLER RD
ANN ARBOR MI
48105-2303
US

V. Phone/Fax

Practice location:
  • Phone: 419-259-2000
  • Fax: 419-213-7631
Mailing address:
  • Phone: 419-259-2000
  • Fax: 419-213-7631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6868
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: