Most Relevant Information
Provider Data
| NPI Number: | 1003382532 |
| Provider Name: | AMANDA ADELE DOUGHERTY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/23/2018 |
| Last Updated: | 10/23/2018 |
Provider Practice Location
3826 PARK AVE STE 102
EDISON
NJ
088202565
Practice Location Phone/Fax
| Phone: | 8482476235 |
| Fax: |
Provider Mailing Location
21600 OXNARD ST STE 1800
WOODLAND HILLS
CA
913677807
Provider Mailing Phone/Fax
| Phone: | 8183452345 |
| Fax: |