Individual
MRS. DEBORAH LYNN DAUGHERTY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3645 BRIARWOOD LANE, BRIARWOOD CLINIC, MUNCIE, IN 47304
(765) 289-5520
Mailing address
3108 GLENVIEW DR, ANDERSON, IN 46012
(765) 378-6730
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34000325
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210926
ANTHEM
IN
Enumeration date
02/03/2006
Last updated
07/08/2007
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