Individual
ELIZABETH ANN DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR
Contact information
Practice address
10640 N RIVERSIDE DR STE 200, FORT WORTH, TX 76244-9506
(817) 431-9000
Mailing address
441 MEADOW PLACE DR APT 4210, WILLOW PARK, TX 76087-6756
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
123644
TX
225XP0200X
Pediatric Occupational Therapist
123644
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123644
OCCUPATIONAL THERAPY
TX
Enumeration date
06/23/2023
Last updated
07/23/2024
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