Individual
DR. SHANNON S DOUGHTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, BCBA
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WP8971
—
SC
Enumeration date
12/13/2006
Last updated
07/08/2007
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