Individual
DR. KEVIN RICHARD DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1910 WABASH AVE, LINWOOD, NJ 08221-1451
(609) 926-9668
(609) 926-4153
Mailing address
1910 WABASH AVE, LINWOOD, NJ 08221-1451
(609) 926-9668
(609) 926-4153
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00327200
NJ
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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