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Individual

DIANA LEIGH DAUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
456 SUITE C MARKET PLACE MALL, WESTON, WV 26452
(304) 517-1401
(304) 517-1404
Mailing address
456 SUITE C MARKET PLACE MALL, WESTON, WV 26452
(304) 517-1401
(304) 517-1404

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A0268
WV
237600000X
Audiologist-Hearing Aid Fitter
A0268
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810018309
WV
Enumeration date
07/23/2010
Last updated
11/12/2014
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