Provider Demographics
NPI:1942799911
Name:YOUNG, DAVID CORT (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CORT
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BRACKENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-4529
Mailing Address - Country:US
Mailing Address - Phone:603-888-9730
Mailing Address - Fax:
Practice Address - Street 1:11 BRACKENWOOD DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-4529
Practice Address - Country:US
Practice Address - Phone:603-888-9730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-06
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6345103TC0700X
NH625103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical