Provider Demographics
NPI:1336815422
Name:YOUNT, KATHRYN H (LMT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:H
Last Name:YOUNT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 EUCLID AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5125
Mailing Address - Country:US
Mailing Address - Phone:972-839-8954
Mailing Address - Fax:
Practice Address - Street 1:2900 S CONGRESS AVE STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6421
Practice Address - Country:US
Practice Address - Phone:512-507-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT111299225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist