Provider Demographics
NPI:1780967935
Name:DOTY, PAULA KAY (CCC/SLP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:KAY
Last Name:DOTY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4544
Mailing Address - Country:US
Mailing Address - Phone:518-761-2025
Mailing Address - Fax:
Practice Address - Street 1:13 LOCUST ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4544
Practice Address - Country:US
Practice Address - Phone:518-761-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015012-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist