Provider Demographics
NPI:1922048610
Name:DOUGHERTY, VIRGINIA DOWLING (MT-BC, MOTR/L)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:DOWLING
Last Name:DOUGHERTY
Suffix:
Gender:F
Credentials:MT-BC, MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 HULTON RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-3408
Mailing Address - Country:US
Mailing Address - Phone:412-798-9434
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE C
Practice Address - Street 2:VAPHS, HJ HEINZ DIVISION, 118-R,
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-784-3821
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1043225A00000X
PAOC006325L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOC006325LOtherOCCUPATIONAL THERAPIST
1043OtherMUSIC THERAPIST, BD. CERT
1027066OtherREGISTRATION NBCOT