Individual
JESSICA CATHERINE DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 AMERICA AVE UNIT 108, LAKEWOOD, NJ 08701-4581
(215) 550-1360
Mailing address
15 AMERICA AVE UNIT 108, LAKEWOOD, NJ 08701-4581
(215) 550-1360
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL014099
PA
Other
Enumeration date
11/25/2019
Last updated
09/03/2020
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