Kenda Marae Dougherty, CCC -SLP | |
117 State St N, Waseca, MN 56093-2928 | |
(507) 237-6336 | |
Not Available |
Full Name | Kenda Marae Dougherty |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 117 State St N, Waseca, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760681746 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 8200 (Minnesota) | Primary |
Provider Name | Waseca Integrated Therapy Hub, Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1851945919 PECOS PAC ID: 4981030491 Enrollment ID: O20200131001575 |
Mailing Address | Practice Location Address |
---|---|
Kenda Marae Dougherty, CCC -SLP 117 State St N, Waseca, MN 56093-2928 Ph: (507) 237-6336 | Kenda Marae Dougherty, CCC -SLP 117 State St N, Waseca, MN 56093-2928 Ph: (507) 237-6336 |
Savannah Kathryn Lenarz, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 117 State St N, Waseca, MN 56093 Phone: 507-237-6336 | |
Waseca Integrated Therapy Hub, Llc Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 117 State St N, Waseca, MN 56093 Phone: 507-237-6336 | |
Christine Dauck, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 117 State St N, Waseca, MN 56093 Phone: 507-237-6336 |