Provider Demographics
NPI:1598907032
Name:DOUGHTY, DEBBY ELLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBBY
Middle Name:ELLA
Last Name:DOUGHTY
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 1:1485 HEALTH CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6492
Mailing Address - Country:US
Mailing Address - Phone:405-494-7106
Mailing Address - Fax:405-494-7525
Practice Address - Street 1:1485 HEALTH CENTER PKWY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6492
Practice Address - Country:US
Practice Address - Phone:405-494-7106
Practice Address - Fax:405-494-7525
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1117103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical