Individual
LYNDA ELYZABETH DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
11 ROUTE 111, SMITHTOWN, NY 11787-3754
(631) 920-8306
Mailing address
14202 20TH AVE, FLUSHING, NY 11351-3000
(631) 920-8306
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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