Healthcare Provider Details

I. General information

NPI: 1437064359
Provider Name (Legal Business Name): KATHRYN DOHERTY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 GEORGE ST
LOWELL MA
01852-2228
US

IV. Provider business mailing address

8 HILLCREST DR
CHELMSFORD MA
01824-1328
US

V. Phone/Fax

Practice location:
  • Phone: 978-453-5736
  • Fax:
Mailing address:
  • Phone: 978-995-3236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: