Individual
MRS. SUSAN L DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1545 W US HIGHWAY 30, SCHERERVILLE, IN 46375-1562
(219) 836-5381
Mailing address
10133 DEVONSHIRE LN, MUNSTER, IN 46321-4376
(219) 718-2699
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000180A
IN
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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