Individual provider · Type 1 NPI
Jill Regina Dougherty, MA, LPCC
Professional Counselor · Rio Rancho, NM
NPI number
1104912930
Active
Practice location
1800 35th Street, SE
Rio Rancho, NM 87124
Fax (505) 892-4658
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | 0099771 (NM) |
| Professional Counselor Primary | 101YP2500X | 0122691 (NM) |
Professional Counselor: Definition to come...
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About NPI 1104912930
Jill Regina Dougherty, MA, LPCC's National Provider Identifier is 1104912930, issued on Oct 5, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Rio Rancho, NM. The record was last updated on May 15, 2009.