Individual
MS. MARY K DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1204 HOLLY LANE, GLEN MILLS, PA 19342
(610) 892-3800
(484) 468-1412
Mailing address
1204 HOLLY LANE, GLEN MILLS, PA 19342
(610) 892-3800
(484) 468-1412
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS004330L
PA
Other
Enumeration date
10/03/2006
Last updated
12/05/2008
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