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General NPI Number Information
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NPI Number | 1548469711
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Entity Type | Organization
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Legal Business Name | STUART YOUNG, PH.D. ASSOCIATES P.A.
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 302 3RD ST SUITE 3
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5131
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Country | US
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Telephone | 904-241-0666
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Fax | 904-241-0289
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Provider Business Mailing Address
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Address Line | 302 3RD ST SUITE 3
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266-5131
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Country | US
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Telephone | 904-241-0666
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Fax | 904-241-0289
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ALEXANDER STUART YOUNG
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Credential | PH.D.
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Telephone | 904-241-0666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 2703
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License Number State | FL
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