Provider Demographics
NPI:1346463882
Name:DOCHERTY, NANCY MARSH (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:MARSH
Last Name:DOCHERTY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KENT STATE UNIVERSITY
Mailing Address - Street 2:DEPT OF PSYCHOLOGY
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44242-0001
Mailing Address - Country:US
Mailing Address - Phone:330-672-7670
Mailing Address - Fax:
Practice Address - Street 1:KENT STATE UNIVERSITY
Practice Address - Street 2:DEPT OF PSYCHOLOGY
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44242-0001
Practice Address - Country:US
Practice Address - Phone:330-672-7670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5111103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical