Individual
JESSICA DOERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2025 ROUTE 9W, RCS HIGH SCHOOL, RAVENA, NY 12186
(518) 756-5200
Mailing address
2025 ROUTE 9W, RCS HIGH SCHOOL, RAVENA, NY 12186
(518) 756-5200
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
080008
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080008
—
NY
Enumeration date
10/17/2012
Last updated
10/17/2012
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