Dougherty, Susanna Dani Electa

Dougherty, Susanna Dani Electa is an sole proprietor health care provider with primary practice located at 40 Pohakulani St , Hilo HI 96720-3116. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Other Service Providers / Midwife. Other Service Providers / Midwife is her primary health care specialty. Dougherty, Susanna Dani Electa can be contacted via phone (808) 990-0394.

Contact Information

Primary practice address
40 Pohakulani St Hilo HI 96720-3116
Phone: (808) 990-0394
Fax: (888) 977-3122
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X
Other Service Providers / Midwife 176B00000X MW-9 Hawaii

Profile Details

NPI number 1518252634
LBN Legal business name Dougherty, Susanna Dani Electa
Credentials CPM, LM, PCES
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2011
Last updated Nov 22nd, 2021 - about 4 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518252634 NPPES
Hawaii Other MW-9 HAWAII LICENCE NUMBER

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