Individual
KEITH DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
368 S MAYO TRL, PIKEVILLE, KY 41501-1522
(606) 437-0047
Mailing address
368 S MAYO TRL, PIKEVILLE, KY 41501-1522
(606) 437-0047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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