person
Tamara Marie Dougherty, CSAC
Addiction (Substance Use Disorder) Counselor in West Bend, Wisconsin
NPI 1467647677

Tamara Marie Dougherty is an Addiction (Substance Use Disorder) Counselor based in West Bend, WI and is specialized in Addiction (Substance Use Disorder). Tamara Marie Dougherty practices in West Bend, WI and has the professional credentials of CSAC. The NPI Number for Tamara Marie Dougherty is 1467647677 and holds a License No. 15350-132 (Wisconsin).

The current practice location address for Tamara Marie Dougherty is 400 W River Dr, West Bend, WI and can be reached out via phone at 262-338-2717 and via fax at 262-338-9767.

Location: 400 W River Dr, West Bend, WI, 53090-1567
person
Provider Profile Details
NPI Number
1467647677
Provider Name
Tamara Marie Dougherty
Credential
CSAC
Provider Entity Type
Individual
Gender
Female
Address
400 W River Dr, West Bend, WI, 53090-1567
Phone Number
262-338-2717
Fax Number
262-338-9767
Provider Enumeration Date
09/11/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
39179600 05 WI
institution
Provider Business Practice Location Address Details
Address
400 W River Dr
City
State
Zip
53090-1567
Phone Number
262-338-2717
Fax Number
262-338-9767
person
Provider Business Mailing Address Details
Address
400 W River Dr
City
State
Zip
53090-1567
Phone Number
262-338-2717
Fax Number
262-338-9767
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
15350-132 (Wisconsin)
Definition
Definition to come...
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