Individual
SAMANTHA DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1200 GRUBB RD, PALMYRA, PA 17078-3514
(717) 838-5406
Mailing address
107 BROOK LN, MARYSVILLE, PA 17053-9500
(334) 414-2189
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP009960
PA
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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