Individual
HEIDI M DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1001 SYCAMORE LN, DANVILLE, IN 46122-1474
(317) 501-6912
Mailing address
114 BLUEBIRD HL, TERRE HAUTE, IN 47803-1450
(812) 230-2925
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003252A
IN
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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