Individual
MADISON DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
38800 CREEKSIDE LOOP APT 203, SANDY, OR 97055-7837
(435) 640-2668
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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