Individual
MRS. ERICA RENEE DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
210 CHARLES ST, KING OF PRUSSIA, PA 19406-2507
(610) 306-6495
Mailing address
210 CHARLES ST, KING OF PRUSSIA, PA 19406-2507
(610) 306-6495
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146.008401
IL
235Z00000X
Speech-Language Pathologist
Primary
SL007531
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022448120002
—
PA
Enumeration date
03/12/2007
Last updated
05/30/2019
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