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Organization
CHRISTINA DOUGHERTY LCSW
Active
Organization
CHRISTINA DOUGHERTY LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA DOUGHERTY LCSW (OWNER)
(424) 777-0985
Entity
Organization
Contact information
Practice address
1206 N CLARK ST, LOS ANGELES, CA 90069-2002
(813) 270-9335
Mailing address
1206 N CLARK ST, LOS ANGELES, CA 90069-2002
(813) 270-9335
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033961110001
—
PA
Enumeration date
04/04/2016
Last updated
07/28/2020
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