Provider Demographics
NPI:1740587617
Name:DEBBY DOUGHTY, PHD, LLC
Entity Type:Organization
Organization Name:DEBBY DOUGHTY, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBBY
Authorized Official - Middle Name:ELLA
Authorized Official - Last Name:DOUGHTY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-494-7106
Mailing Address - Street 1:501 N MUSTANG RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-7048
Mailing Address - Country:US
Mailing Address - Phone:405-494-7109
Mailing Address - Fax:405-494-7525
Practice Address - Street 1:501 N MUSTANG RD
Practice Address - Street 2:SUITE I
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-7048
Practice Address - Country:US
Practice Address - Phone:405-494-7109
Practice Address - Fax:405-494-7525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1117261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)