Individual
CHRISTOPHER RAY VAN DOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
11 BRICK HILL RD, WINDHAM, ME 04062-3359
(207) 831-9480
Mailing address
95 PARKER ST, C/O HOSA, NEWBURYPORT, MA 01950-4033
(978) 225-2250
(978) 225-2251
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC3069
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431538599
—
ME
Enumeration date
05/08/2007
Last updated
08/02/2010
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