| NPI | 1457852444 |
|---|---|
| Former Name | JENNIFER DOUGHERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-3331) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 018990-1) |
| Enumeration Date | 2018-02-24 |
| Last Update Date | 2018-02-24 |