Individual
AMY WAGNER DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 JAVIT CT, AUSTINTOWN, OH 44515-2439
(330) 797-4050
Mailing address
104 JAVIT CT, AUSTINTOWN, OH 44515-2439
(330) 797-4050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.2202572-TRNE
OH
Other
Enumeration date
08/25/2022
Last updated
08/27/2022
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