Individual
KIMBERLY PINE DOUGHARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPAT
Contact information
Practice address
4730 BECKNER RD, SANTA FE, NM 87507-3691
(505) 989-4500
(505) 443-8313
Mailing address
1009 VELARDE RD, SANTA FE, NM 87507-5126
(253) 720-4871
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
CTB20230922
NM
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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