MEDICARE: DESIREE FRANCENE DOUCHETTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	3595	SC

General Provider Information

NPI Number	:	1194262576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESIREE FRANCENE DOUCHETTE

Provider Business Mailing Address
First Line	:	1100 CIRCLE 75 PKWY SE STE 1400
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-3067
Country	:	US
Telephone Number	:	843-682-7301
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 WILLIAM HILTON PKWY STE 105
Second Line	:
City	:	HILTON HEAD
State	:	SC
Zip	:	29926-2404
Country	:	US
Telephone Number	:	843-682-7301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2017
Last Update Date	:	02/06/2026

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Directions to “ DESIREE FRANCENE DOUCHETTE ” Practice Location

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