Dougherty, Diane L

Dougherty, Diane L is an individual health care provider with primary practice located at 4301 Garth Rd Suite 400, Baytown TX 77521. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dougherty, Diane L can be contacted via phone (281) 420-8400.

Contact Information

Primary practice address
4301 Garth Rd Suite 400 Baytown TX 77521
Phone: (281) 420-8400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3323 Texas
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2-4826 Texas
Behavioral Health & Social Service Providers / Clinical 103TC0700X 24826 Texas

Profile Details

NPI number 1558343939
LBN Legal business name Dougherty, Diane L
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Sep 12th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558343939 NPPES
Texas MEDICAID 091752801

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