Individual
LINDA DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRC, QRP
Contact information
Practice address
30 SUN VLY, GLEN DALE, WV 26038-1222
(304) 845-1836
(304) 843-1783
Mailing address
30 SUN VLY, GLEN DALE, WV 26038-1222
(304) 845-1836
(304) 843-1783
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00047827
CRC
—
Enumeration date
01/02/2008
Last updated
01/02/2008
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