Individual
ELIZABETH ANN DOHERTY I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72 KILBURN ST, NEW BEDFORD, MA 02740-7321
(774) 213-8448
Mailing address
72 KILBURN ST, NEW BEDFORD, MA 02740-7321
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1507
LADC 11
MA
Enumeration date
10/17/2017
Last updated
10/17/2017
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