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Individual

ROBERT LEE DAUGHERTY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MFT

Contact information

Practice address
201 CREST ST, BURLINGTON, WI 53105-1952
(262) 767-0440
(262) 767-0777
Mailing address
201 CREST ST, BURLINGTON, WI 53105-1952
(262) 767-0440
(262) 767-0777

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
234124
WI

Other

Enumeration date
04/19/2006
Last updated
07/08/2007
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