Provider Demographics
NPI:1124014626
Name:YOUNG, ELIZABETH WOLCOTT (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:WOLCOTT
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S 2000 E
Mailing Address - Street 2:RM 201
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84112-5820
Mailing Address - Country:US
Mailing Address - Phone:801-213-3421
Mailing Address - Fax:801-585-6599
Practice Address - Street 1:30 S 2000 E
Practice Address - Street 2:RM 201
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5820
Practice Address - Country:US
Practice Address - Phone:801-213-3421
Practice Address - Fax:801-585-6599
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT152383-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy