Individual
VICTORIA MICHELLE DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
721 CHUCK GRAY CT, OWENSBORO, KY 42303-7308
(270) 702-4641
Mailing address
1321 MURFREESBORO PIKE STE 702, NASHVILLE, TN 37217-2679
(615) 361-4000
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-59558
KY
Other
Enumeration date
08/07/2019
Last updated
08/16/2022
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