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Individual

CARL NEAL DAUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
119 PEDIGO RD, SUITE F, MADISONVILLE, TN 37354-4438
(423) 442-5280
(423) 442-8127
Mailing address
DEPT 888182, KNOXVILLE, TN 37995-0001
(800) 355-3565
(423) 714-2355

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
7611
TN

Other

Enumeration date
07/14/2008
Last updated
09/08/2008
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