| NPI | 1720656820 |
|---|---|
| Former Name | KIMBERLY ANNE DOUGHERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00330300) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00749600) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2024-11-03 |