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Individual

SUSANNA DANI ELECTA DOUGHERTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPM, LM, PCES

Contact information

Practice address
40 POHAKULANI ST, HILO, HI 96720-3116
(808) 990-0394
(888) 977-3122
Mailing address
PO BOX 551794, KAPAAU, HI 96755-1794
(808) 990-0394

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MW-9
HI
2255A2300X
Athletic Trainer

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MW-9
HAWAII LICENCE NUMBER
HI
Enumeration date
06/16/2011
Last updated
11/22/2021
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