Individual
KAYLEE LIZABETH DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCO, CCA
Contact information
Practice address
133 MORTLAND RD, SEARSPORT, ME 04974-3337
(800) 824-2492
(877) 824-2413
Mailing address
PO BOX 245, SEARSPORT, ME 04974-0245
(800) 824-2492
(877) 824-2413
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
229N00000X
Anaplastologist
—
—
Other
Enumeration date
11/06/2018
Last updated
05/06/2020
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