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General NPI Number Information
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NPI Number | 1891719977
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Entity Type | Individual
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Provider Name | ROBERT W YOUNG JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 5413 GEORGE ST SUITE 2
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4101
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Country | US
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Telephone | 727-848-0840
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Fax | 727-255-5075
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Provider Business Mailing Address
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Address Line | 5413 GEORGE ST SUITE 2
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4101
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Country | US
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Telephone | 727-848-0840
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Fax | 727-255-5075
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6915
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License Number State | FL
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