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1346494895
CHARLES ANTHONY DORAM
MONONA, WI
NPI
1346494895
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 312574)
Enumeration Date
2008-11-11
Last Update Date
2008-11-12
Business Address
-- CHARLES ANTHONY DORAM CSAC
2829 ROYAL AVE
MONONA, WI 53713-1535
Phone number: 608-661-2829
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Mailing Address
-- CHARLES ANTHONY DORAM CSAC
2829 ROYAL AVE STE 200
MONONA, WI 53713-1535
Phone number: 608-661-2829
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