Provider Demographics
NPI:1629289640
Name:YUND, STEVEN CHARLES (MA)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:CHARLES
Last Name:YUND
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29484 HOLLY ST NW
Mailing Address - Street 2:
Mailing Address - City:ISANTI
Mailing Address - State:MN
Mailing Address - Zip Code:55040-8032
Mailing Address - Country:US
Mailing Address - Phone:763-444-6579
Mailing Address - Fax:
Practice Address - Street 1:29484 HOLLY ST NW
Practice Address - Street 2:
Practice Address - City:ISANTI
Practice Address - State:MN
Practice Address - Zip Code:55040-8032
Practice Address - Country:US
Practice Address - Phone:763-444-6579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3162103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral