Individual
MS. CARISSA ANNE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4019 MANCHACA RD, AUSTIN, TX 78704-6737
(512) 804-3414
(512) 447-2213
Mailing address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 445-7787
(512) 440-4059
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
36018
TX
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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