Individual
THEA DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
652 ROUTE 12, FLEMINGTON, NJ 08822-2716
(908) 947-5634
Mailing address
652 ROUTE 12, FLEMINGTON, NJ 08822-2716
(908) 947-5634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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