Amanda Marie Dougherty
NPI #1033958848 in Bloomington, Minnesota
Provider Information
- NPI Number
- 1033958848
- Entity Type
- Individual
- Name
- Amanda Marie Dougherty
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Clinic/Center - Adolescent and Children Mental Health
- Enumeration Date
- May 21, 2024
- Last Updated
- May 21, 2024
Practice Location
- Address
- 9358 ENSIGN AVE S
- City
- Bloomington
- State
- Minnesota
- ZIP Code
- 55438-1472
- Phone
- (952) 666-2289
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
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