Dougherty, Kim A.
Dougherty, Kim A. is an sole proprietor health care provider with primary practice located at 211 Nautica Mile Dr , Clermont FL 34711-2474. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Dougherty, Kim A. can be contacted via phone (352) 255-3629.Contact Information
Primary practice address
211 Nautica Mile Dr
Clermont FL 34711-2474
Phone: (352) 255-3629
Fax: (407) 295-5808
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA7063 | Florida |
Profile Details
NPI number | 1407813363 |
---|---|
LBN Legal business name | Dougherty, Kim A. |
Credentials | Master of Arts (MA) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 26th, 2006 |
Last updated | Mar 13th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407813363 | NPPES |
Florida | MEDICAID | 889799900 |
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