Individual
KATHERINE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
9346 OAK AVE, WACONIA, MN 55387-9422
(952) 223-2506
Mailing address
1121 19TH ST NE, ROCHESTER, MN 55906-4285
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225400000X
Rehabilitation Practitioner
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
07/03/2024
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