Individual
AMANDA RUTH DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCII, QMHAR, CGACR
Contact information
Practice address
350 E 11TH AVE, EUGENE, OR 97401-3246
(541) 683-1641
Mailing address
350 E 11TH AVE, EUGENE, OR 97401-3246
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
24-QMHA-R-5172
OR
Other
Enumeration date
04/07/2021
Last updated
08/07/2024
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