Individual
CHRISTINE E DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5 RAVEN LN, LAKEWOOD, NJ 08701-4968
(732) 730-0700
Mailing address
353 RIVERDALE DR, KEYPORT, NJ 07735-5022
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-24077
—
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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