| Christina Dougherty Lcsw | |
|
1206 N Clark St Los Angeles CA 90069-2002 | |
| (813) 270-9335 | |
| Not Available |
| Full Name | Christina Dougherty Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1206 N Clark St, Los Angeles, California |
| Authorized Official Name and Position | Christina Dougherty (OWNER) |
| Authorized Official Contact | 4247770985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christina Dougherty Lcsw 1206 N Clark St Los Angeles CA 90069-2002 Ph: (813) 270-9335 | Christina Dougherty Lcsw 1206 N Clark St Los Angeles CA 90069-2002 Ph: (813) 270-9335 |
| NPI Number | 1386007425 |
|---|---|
| Provider Enumeration Date | 04/04/2016 |
| Last Update Date | 07/28/2020 |
| Certification Date | 07/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386007425 | NPI | - | NPPES |
| 1033961110001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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