| Sean Dougherty Pc | |
|
967 Spaulding Ave Se Ste E Ada MI 49301-3703 | |
| (616) 504-1002 | |
| Not Available |
| Full Name | Sean Dougherty Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 967 Spaulding Ave Se Ste E, Ada, Michigan |
| Authorized Official Name and Position | Sean Dougherty (PROVIDER) |
| Authorized Official Contact | 6165041002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sean Dougherty Pc 967 Spaulding Ave Se Ste E Ada MI 49301-3703 Ph: (616) 504-1002 | Sean Dougherty Pc 967 Spaulding Ave Se Ste E Ada MI 49301-3703 Ph: (616) 504-1002 |
| NPI Number | 1558139238 |
|---|---|
| Provider Enumeration Date | 12/13/2023 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558139238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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