| Sally S. Young Phd, Professional Corporation | |
|
86 Lake St Office 307 Burlington VT 05401-5297 | |
| (802) 862-2773 | |
| (802) 862-6496 |
| Full Name | Sally S. Young Phd, Professional Corporation |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 86 Lake St, Burlington, Vermont |
| Authorized Official Name and Position | Sally Serrell Young (LICENSED PSYCHOLOGIST - DOCTORATE) |
| Authorized Official Contact | 8028622773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally S. Young Phd, Professional Corporation Po Box 626 Burlington VT 05402-0626 Ph: (802) 862-2773 | Sally S. Young Phd, Professional Corporation 86 Lake St Office 307 Burlington VT 05401-5297 Ph: (802) 862-2773 |
| NPI Number | 1619050143 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 03/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619050143 | NPI | - | NPPES |
| 0008363 | Other | VT | PTAN |
| VT6583 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 480000178 (Vermont) | Primary |
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