Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 019805-1 | NY |
NPI | 1063678787 |
---|---|
Provider Name | Dr. Christina Marie Doherty |
First Address | White Plains, NY 10605-3824 |
Second Address | White Plains, NY 10605-3824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2008 |
Last Update Date | 23/04/2018 |