Individual
DR. BERNADETTE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
22 N PENNELL RD, MEDIA, PA 19063-5520
(215) 770-1845
Mailing address
22 N PENNELL RD, MEDIA, PA 19063-5520
(215) 770-1845
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS019625
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2020
Last updated
01/06/2023
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