Individual
STEPHANIE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 N 6TH AVE, LEBANON, PA 17046-4065
(717) 274-9682
Mailing address
200 N 7TH ST, LEBANON, PA 17046-5040
(717) 272-5464
(717) 376-1712
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BH004768
PA
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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