Individual
KRISTEN ANN DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2861 CHESTER ST, OCEANSIDE, NY 11572-1233
(516) 528-1915
Mailing address
2861 CHESTER ST, OCEANSIDE, NY 11572-1233
(516) 528-1915
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1114167
NY
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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