Provider Demographics
NPI:1477764454
Name:DOUGHTY, BARBARA RUTH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:RUTH
Last Name:DOUGHTY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:DOUGHTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:373 CAROL DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-3733
Mailing Address - Country:US
Mailing Address - Phone:406-455-5238
Mailing Address - Fax:406-455-4591
Practice Address - Street 1:1101 26TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5161
Practice Address - Country:US
Practice Address - Phone:406-455-5238
Practice Address - Fax:406-455-4591
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT931235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist