Individual
BRENNA ELISE DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5514 BONN WAY, SAINT CLOUD, FL 34771-9434
(508) 272-8124
Mailing address
5514 BONN WAY, SAINT CLOUD, FL 34771-9434
(508) 272-8124
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA18115
FL
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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