Individual
CHARLES ANTHONY DORAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
2829 ROYAL AVE, MONONA, WI 53713-1535
(608) 661-2829
(608) 661-0907
Mailing address
2829 ROYAL AVE STE 200, MONONA, WI 53713-1535
(608) 661-2829
(608) 661-0907
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
312574
WI
Other
Enumeration date
11/11/2008
Last updated
11/12/2008
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