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1194005181
SHANNON RAE DOCHERTY
LOS ANGELES, CA
NPI
1194005181
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 81272)
Enumeration Date
2011-08-22
Last Update Date
2018-08-20
Business Address
SHANNON RAE DOCHERTY
444 N LARCHMONT BLVD STE 109
LOS ANGELES, CA 90004
Phone number: 716-868-5732
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Mailing Address
SHANNON RAE DOCHERTY
438 1/2 S DETROIT ST
LOS ANGELES, CA 90036-3533
Phone number: 716-868-5732
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