Individual
PORTIA DOUGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
224 WEST D.L. INGRAM AVE., CANNON AFB, NM 88103
(575) 784-1108
Mailing address
224 WEST D.L. INGRAM AVE., CANNON AFB, NM 88103
(575) 784-1108
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C019277
NC
1041C0700X
Clinical Social Worker
SWB-2026-0148
NM
Other
Enumeration date
04/17/2023
Last updated
03/02/2026
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