Susanna Dani Electa Dougherty, CPM, LM, PCES

NPI #1518252634 in Hilo, Hawaii

Provider Information

NPI Number: 1518252634
Entity Type: Individual
Name: Susanna Dani Electa Dougherty, CPM, LM, PCES
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Midwife
Credential: CPM, LM, PCES
Enumeration Date: Jun 16, 2011
Last Updated: Nov 22, 2021

Practice Location

Address: 40 POHAKULANI ST
City: Hilo
State: Hawaii
ZIP Code: 96720-3116
Phone: (808) 990-0394

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Midwife	176B00000X	Primary

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