Doctor Name: | MR. JOSEPH LARKEN DOUGHTY |
NPI Number: | 1194878041 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.P.C. |
License Number: | 185 |
Business Practice Address: | 1313 Ringgold Ave Coushatta, LA - 71019 |
Business Phone Number: | 3189324029 |
Business Fax Number: | 3189325914 |
Mailing Address: | 302 Dalton Ranch Rd, CAMPTI |
State: | LA |
Postal Code: | 714114558 |
Phone Number: | 3184762245 |
Fax Number: | |
NPI Enumeration Date: | 01/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 185 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |