Daugherty, Timothy Kenneth
Daugherty, Timothy Kenneth is an individual health care provider with primary practice located at 1601 Ebenezer Rd , Rock Hill SC 29732-1808. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Daugherty, Timothy Kenneth can be contacted via phone (803) 322-5695.Contact Information
Primary practice address
1601 Ebenezer Rd
Rock Hill SC 29732-1808
Phone: (803) 322-5695
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 556 | South Carolina |
Profile Details
| NPI number | 1134168099 |
|---|---|
| LBN Legal business name | Daugherty, Timothy Kenneth |
| Credentials | PH.D., ABPP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134168099 | NPPES |
| South Carolina | MEDICAID | PS0208 |
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