Individual
MS. CAROLYN RUTH DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2554 LAKE DEBRA DR APT 25102, ORLANDO, FL 32835-8711
(781) 243-9653
Mailing address
2554 LAKE DEBRA DR APT 25102, ORLANDO, FL 32835-8711
(781) 243-9653
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW16200
FL
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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