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Individual

WILLIAM G DOUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
4100 LAKE OTIS PKWY, STE 314, ANCHORAGE, AK 99508-5231
(907) 274-2425
(907) 274-2428
Mailing address
PO BOX 241769, ANCHORAGE, AK 99524-1769
(907) 770-2380
(907) 770-2341

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1089
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OT1089
AK
Enumeration date
03/09/2006
Last updated
08/26/2010
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