Provider Demographics
NPI:1366014722
Name:DOUCETTE, DESIREE A
Entity type:Individual
Prefix:MISS
First Name:DESIREE
Middle Name:A
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 WARD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2409
Mailing Address - Country:US
Mailing Address - Phone:716-418-3361
Mailing Address - Fax:
Practice Address - Street 1:1419 UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2936
Practice Address - Country:US
Practice Address - Phone:716-580-3976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist