Dougherty, Shannon Marie

Dougherty, Shannon Marie is an individual health care provider with primary practice located at 5501 Old York Rd Hb-Ground, Philadelphia PA 19141-3018. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Dougherty, Shannon Marie can be contacted via phone (215) 456-6649.

Contact Information

Primary practice address
5501 Old York Rd Hb-Ground Philadelphia PA 19141-3018
Phone: (215) 456-6649
Fax: (215) 456-4992
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X

Profile Details

NPI number 1801926167
LBN Legal business name Dougherty, Shannon Marie
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Jul 8th, 2007 - about 18 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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