Individual
DEVIN LEE DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
116 E 32ND ST, MARION, IN 46953-4060
(765) 662-2039
Mailing address
505 N WABASH AVE, MARION, IN 46952-2608
(765) 662-3971
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33012286A
IN
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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