Dougherty-Lake, Jane
Dougherty-Lake, Jane is an sole proprietor health care provider with primary practice located at 167 North Main Street , Tuba City AZ 86045. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Dougherty-Lake, Jane can be contacted via phone (928) 283-2497.Contact Information
Primary practice address
167 North Main Street
Tuba City AZ 86045
Phone: (928) 283-2497
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X |
Profile Details
| NPI number | 1720110885 |
|---|---|
| LBN Legal business name | Dougherty-Lake, Jane |
| Credentials | Registered Dietitian (RD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 12th, 2007 |
| 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.
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