Jill Regina Dougherty, MA, LPCC
Counselor, Professional in Rio Rancho, NM. Individual provider (NPI-1).
NPI number1104912930
StatusActive
Last updated in NPPESMay 15, 2009
Details
- NPI
- 1104912930
- Entity type
- Individual (NPI-1)
- Name
- Ms. Jill Regina Dougherty
- Credential
- MA, LPCC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 5, 2006
- Last updated
- May 15, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 0122691 | NM | Yes |
| 101YM0800X | Counselor, Mental Health | 0099771 | NM |
Practice location
1800 35th Street, SeRio Rancho, NM 87124
Phone 505-892-8640 · Fax 505-892-4658
Mailing address
1800 35th Street, SeRio Rancho, NM 87124
Phone 505-892-8640 · Fax 505-892-4658
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