Individual
DR. TIMOTHY KENNETH DAUGHERTY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D., ABPP
Contact information
Practice address
1601 EBENEZER RD, ROCK HILL, SC 29732-1808
(803) 322-5695
Mailing address
1998 ALDERSGATE RD, ROCK HILL, SC 29732-1355
(803) 322-5695
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
556
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0208
—
SC
Enumeration date
06/06/2006
Last updated
07/08/2007
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