Individual
LAURA SEMON DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J1-0002369
DE
174400000X
Specialist
PT013595L
PA
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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