Provider Demographics
NPI:1588904437
Name:DOUGHRITY, LORI MICHELLE (BA, LSST)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:MICHELLE
Last Name:DOUGHRITY
Suffix:
Gender:F
Credentials:BA, LSST
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6309 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-2302
Mailing Address - Country:US
Mailing Address - Phone:313-605-7896
Mailing Address - Fax:313-285-2430
Practice Address - Street 1:6309 MACK AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-2302
Practice Address - Country:US
Practice Address - Phone:313-605-7896
Practice Address - Fax:313-285-2430
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical