Individual
JONATHON DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
1960 N DATE ST, TRUTH OR CONSEQUENCES, NM 87901-3701
(575) 894-7662
(575) 894-7930
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0120801
NM
Other
Enumeration date
11/09/2006
Last updated
04/09/2013
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