| Doctor Name: | TIMOTHY YOUNG |
| NPI Number: | 1366814691 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 12283 |
| Business Practice Address: | 1620 Fm 535 Smithville, TX - 789575038 |
| Business Phone Number: | 5123603600 |
| Business Fax Number: | 5122373699 |
| Mailing Address: | 1620 Fm 535, SMITHVILLE |
| State: | TX |
| Postal Code: | 789575038 |
| Phone Number: | 5123603600 |
| Fax Number: | 5122373699 |
| NPI Enumeration Date: | 10/26/2015 |
| NPI Last Update Date: | 10/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 12283 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |