Individual
PROF. JOHN DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 W FIRETOWER RD STE D, WINTERVILLE, NC 28590-8408
(252) 830-3300
(252) 830-3322
Mailing address
108 W FIRETOWER RD STE D, WINTERVILLE, NC 28590-8408
(252) 830-3300
(252) 830-3322
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
1094
NC
106H00000X
Marriage & Family Therapist
411
NC
Other
Enumeration date
03/23/2007
Last updated
10/17/2013
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