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Individual
AMANDA RUTH DOUGHERTY
Active
Individual
AMANDA RUTH DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCII, QMHA, CGAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-01-20380
OR
101YM0800X
Mental Health Counselor
24-QMHA-I-004720
OR
101YM0800X
Mental Health Counselor
24-QMHA-R-5172
OR
Other
Enumeration date
04/07/2021
Last updated
06/15/2026
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