Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mallory Boteler Dougherty, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1881982551

Mrs. Mallory Boteler Dougherty, MS, CCC-SLP is a Speech-Language Pathologist in Tyler, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2011
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

921 Shiloh Rd #120
Tyler, TX 75703-1431
Phone: (903) 939-2800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 107640 (TX)

Record details

NPI number1881982551
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorYes
NPI enumeratedJuly 15, 2011
Last updated in NPPESAugust 20, 2015

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