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Individual

DEVAN DOHERTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CACII

Contact information

Practice address
2 S MAIN ST STE 206, WATKINSVILLE, GA 30677-7101
(706) 991-9865
(424) 220-7408
Mailing address
105 WHITEHEAD RD APT 13, ATHENS, GA 30606-1552
(706) 206-0892
(424) 220-7408

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3669
GA

Other

Enumeration date
08/01/2024
Last updated
08/01/2024
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