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Individual

MS. SHACORA DAUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1315 WALNUT ST, SUITE NUMBER 200, PHILADELPHIA, PA 19107-4719
(215) 670-5956
(215) 546-1633
Mailing address
2200 BENJAMIN FRANKLIN PKWY, APT#E308, PHILADELPHIA, PA 19130-3601
(215) 670-9555
(215) 546-1633

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/21/2007
Last updated
07/08/2007
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