Individual
MRS. MICHELLE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 ROUTE 73 NORTH, SUITE 104, MARLTON, NJ 08053-3422
(609) 575-2661
Mailing address
525 ROUTE 73 N STE 104, MARLTON, NJ 08053-3422
(609) 575-2661
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00540700
NJ
Other
Enumeration date
11/30/2012
Last updated
09/06/2020
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