Individual
DR. ELLEN ELSIE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
800 IRVING AVE, BEHAVIORAL HEALTH OUTPATIENT CLINIC, SYRACUSE, NY 13210-2716
(315) 425-4400
Mailing address
800 IRVING AVE, BEHAVIORAL HEALTH OUTPATIENT CLINIC, SYRACUSE, NY 13210-2716
(315) 425-4400
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017979
NY
Other
Enumeration date
02/16/2009
Last updated
02/16/2009
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