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General NPI Number Information
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NPI Number | 1699280214
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Entity Type | Individual
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Provider Name | APRIL DAUGHERTY
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Gender | Female
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 2915 S BURLESON BLVD
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City | BURLESON
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State | TX
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Zip | 76028-1878
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Country | US
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Telephone | 817-447-3001
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11412
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City | FORT WORTH
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State | TX
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Zip | 76110-0412
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Country | US
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Telephone | 214-437-4884
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 64437
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License Number State | TX
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