Provider Demographics
NPI:1790351013
Name:DOUGHERTY, EMILY (SLPA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DOUGHERTY
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 N MACARTHUR BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1860
Mailing Address - Country:US
Mailing Address - Phone:405-464-9595
Mailing Address - Fax:
Practice Address - Street 1:11900 N MACARTHUR BLVD STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1860
Practice Address - Country:US
Practice Address - Phone:405-464-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant