Dwight Young LCP

NPI 1699966507 - Psychologist - 103TP2701X

NPI Details
NPI 1699966507
Gender Male
Enumeration Date 08/06/2007
Last Updated 08/06/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
5815 BROADWAY
GREAT BEND KS, 67530, US
Phone (620) 792-2544
Fax (620) 792-7052
Business Location
5815 BROADWAY
GREAT BEND KS, 67530, US
Phone (620) 792-2544
Fax (620) 792-7052
Toxanomy
Taxonomy Code 103TP2701X
License State Kansas
License Number 208
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According to our database, Dwight Young LCP NPI is 1699966507, taxonomy code is 103TP2701X and license number is 208, license state is located at Kansas. Dwight Young LCP physically located at 5815 Broadway, Great Bend KS, 67530. NPI Number Dwight Young LCP has the Individual type.

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1699966507 NPI number is provided on an as is basis without warranty of any kind. 1699966507 is maintained by the National Plan & Provider Enumeration System. The contents of Dwight Young LCP are for informational purposes only.