| NPI | 1023372091 |
|---|---|
| Former Name | ROSEANN DOHERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 657266) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: NY 1701205) | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2020-11-04 |