Individual
JESSIE DOUGHTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 HOWARD AVE, MAPLE PLAIN, MN 55359-9644
(612) 240-6597
Mailing address
1725 HOWARD AVE, MAPLE PLAIN, MN 55359-9644
(612) 240-6597
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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