Individual
ELIZABETH AUTUMN DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 N TAYLOR ST, ARLINGTON, VA 22203-1858
(703) 516-9455
Mailing address
900 N TAYLOR ST, ARLINGTON, VA 22203-1858
(703) 516-9455
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000427
VA
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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