Individual
KATHLEEN MARY DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4208 ALDERSHOT CT, APT. E, CHARLOTTE, NC 28211-5092
(704) 258-1724
Mailing address
PO BOX 480462, CHARLOTTE, NC 28269-5320
(704) 258-1724
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8977
NC
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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