Provider Demographics
NPI:1942614656
Name:DAUGHERTY, EMILY STEIN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:STEIN
Last Name:DAUGHERTY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:JUNE
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6711 MOUNTAIN VIEW RD STE 115
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6667
Mailing Address - Country:US
Mailing Address - Phone:423-238-1127
Mailing Address - Fax:423-238-1277
Practice Address - Street 1:4964 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8071
Practice Address - Country:US
Practice Address - Phone:706-866-6414
Practice Address - Fax:706-866-6616
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101672251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ010020Medicaid
GA003155035AMedicaid