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Individual

MS. PATRICIA JUDITH DOHERTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
149 CHERRY ST, BURLINGTON, VT 05401-3817
(866) 843-1722
Mailing address
58 DUGWAY RD, WAITSFIELD, VT 05673-6116

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000877
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
089-0000877
VERMONT PROFESSIONAL REGULATION BOARD
VT
Enumeration date
04/16/2008
Last updated
07/18/2014
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