MEDICARE: DR. TIMOTHY LYNN YOUNG PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	2232	TX

General Provider Information

NPI Number	:	1851425706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY LYNN YOUNG PH.D.

Provider Business Mailing Address
First Line	:	9535 FOREST LN
Second Line	:	SUITE 202
City	:	DALLAS
State	:	TX
Zip	:	75243-5900
Country	:	US
Telephone Number	:	972-907-2477
Fax Number	:	972-907-1331

Provider Business Practice Location Address
First Line	:	9535 FOREST LN
Second Line	:	SUITE 202
City	:	DALLAS
State	:	TX
Zip	:	75243-5900
Country	:	US
Telephone Number	:	972-907-2477
Fax Number	:	972-907-1331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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