Organization
DALLAS NEW LEAF CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER LYNN DOUGHERTY PHD (ASSESSMENT COUNSELOR)
(469) 251-0803
Entity
Organization
Contact information
Practice address
17103 PRESTON RD, SUITE 288, DALLAS, TX 75248-1332
(469) 251-0803
Mailing address
17103 PRESTON RD, SUITE 288, DALLAS, TX 75248-1332
(469) 251-0803
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20192
TX
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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