| Doctor Name: | SALLY R YOUNG |
| NPI Number: | 1124460662 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1387-226 |
| Business Practice Address: | 1268 W Main St # 2 Sun Prairie, WI - 535901930 |
| Business Phone Number: | 6088341132 |
| Business Fax Number: | 7026646958 |
| Mailing Address: | 1268 W Main St # 2, SUN PRAIRIE |
| State: | WI |
| Postal Code: | 535901930 |
| Phone Number: | 6088341132 |
| Fax Number: | 7026646958 |
| NPI Enumeration Date: | 07/25/2013 |
| NPI Last Update Date: | 07/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1387-226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |