Individual
MR. BOJAN DABETIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC
Contact information
Practice address
3113 E WASHINGTON AVE, MADISON, WI 53704-4330
(608) 242-0220
Mailing address
3113 E WASHINGTON AVE, MADISON, WI 53704-4330
(608) 242-0220
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14672-131
WI
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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