Individual
JENNIFER M DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 KELLY COURT, STORMVILLE, NY 12582
(570) 295-0901
Mailing address
2 KELLY CT, STORMVILLE, NY 12582-5609
(570) 295-0901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/18/2010
Last updated
03/05/2014
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