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NPI Code Detail

MEDICARE: SUZANNE DAUGHERTY SLP-CCC

MEDICARE:   SUZANNE  DAUGHERTY  SLP-CCC
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1295154169
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE DAUGHERTY SLP-CCC
Provider Business Mailing Address
First Line : PO BOX 8114
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37414-0114
Country : US
Telephone Number : 423-622-1551
Fax Number : 877-856-7133
Provider Business Practice Location Address
First Line : 2601 BRANSFORD AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37204-2811
Country : US
Telephone Number : 423-622-1551
Fax Number : 877-856-7133
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2014
Last Update Date : 04/08/2014

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Directions to “ SUZANNE DAUGHERTY SLP-CCC” Practice Location

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