Whalio Doctors

NPI 1083927917

Kenneth Ray Young, PSYDLP

Practitioner Psychologist Coon Rapids, MN

Practice location

Address
9055 Springbrook Dr NW, Coon Rapids, MN 55433-5841
Phone
(763) 780-9155
Fax
(763) 236-1066
Mailing address
2925 Chicago Ave, Minneapolis, MN 55407-1321

Registered specialties (4)

Psychologist Primary
Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence LP5036 (MN)
Clinical Psychologist
Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence LP5036 (MN)
Forensic Psychologist
Behavioral Health & Social Service Providers Taxonomy 103TF0200X Licence LP5036 (MN)
Clinical Child & Adolescent Psychologist
Behavioral Health & Social Service Providers Taxonomy 103TC2200X Licence LP5036 (MN)

Registry record

NPI
1083927917
Entity type
Individual
Sex (as registered)
Male
NPI issued
20 Jul 2010
Record last updated
7 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.