Individual
MRS. LISA SUE DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
300 CORPORATE CENTER DR, MANALAPAN, NJ 07726-8736
(732) 761-0088
Mailing address
439 KELLINGTON DR, EAST WINDSOR, NJ 08520-5318
(609) 651-0966
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
46TR00288300
NJ
Other
Enumeration date
02/20/2013
Last updated
02/20/2013
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