Individual
MRS. HOLLY L DOUGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
120 E 4TH ST, KAUKAUNA, WI 54130-2522
(920) 415-4416
Mailing address
120 E 4TH ST, KAUKAUNA, WI 54130-2522
(920) 415-4416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
5799
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048717
—
WI
Enumeration date
10/08/2015
Last updated
05/15/2024
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