Individual
MS. JILL REGINA DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
1800 35TH STREET, SE, RIO RANCHO, NM 87124
(505) 892-8640
(505) 892-4658
Mailing address
1800 35TH STREET, SE, RIO RANCHO, NM 87124
(505) 892-8640
(505) 892-4658
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0099771
NM
101YP2500X
Professional Counselor
Primary
0122691
NM
Other
Enumeration date
10/05/2006
Last updated
05/15/2009
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