Doctor Name: | BRIDGET M. DOHERTY |
NPI Number: | 1104871821 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RNCS |
License Number: | 160620 |
Business Practice Address: | 2 Essex Center Dr Peabody, MA - 019602902 |
Business Phone Number: | 9782506240 |
Business Fax Number: | |
Mailing Address: | 147 Milk St, Provider Enrollment 9th Floor BOSTON |
State: | MA |
Postal Code: | 021094806 |
Phone Number: | 6175598051 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 160620 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |