Individual
ALICIA GRACE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
2600 W 9TH ST, 4TH FLR, CHESTER, PA 19013-2040
(610) 497-7249
Mailing address
227 E FOURTH ST, MEDIA, PA 19063-3008
(610) 566-5197
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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