Tamara Marie Dougherty in West Bend - Addiction (substance Use Disorder)
Tamara Marie Dougherty - NPI 1467647677
Tamara Marie Dougherty is a Addiction (substance Use Disorder) in West Bend, Wisconsin. Tamara Marie Dougherty practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Tamara Marie Dougherty is 1467647677. The last update date is 2009-12-28.
Tamara Marie Dougherty's current location address is 400 W River Dr, West Bend, Wisconsin. You can contact this provider via phone number 2623382717 and fax number 2623389767. The mailing address for Tamara Marie Dougherty is 400 W River Dr, West Bend, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tamara Marie Dougherty |
|---|---|
| Address | 400 W River Dr, West Bend, Wisconsin |
| Phone Number | 2623382717 |
| Fax Number | 2623389767 |
| Sole Proprietor | N |
| Credentials | CSAC |
NPI Number Detail
| NPI Number | 1467647677 |
|---|---|
| Provider Enumeration Date | 2007-09-11 |
| Last Updated Date | 2009-12-28 |
Provider Mailing Address Detail
| Address | 400 W River Dr |
|---|---|
| City | West Bend |
| State | Wisconsin (WI) |
| Post Code | 530901567 |
| Phone Number | 2623382717 |
| Fax Number | 2623389767 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 15350-132 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39179600 | WI | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Tamara Marie Dougherty?
The Tamara Marie Dougherty has been issued the NPI (National Provider Identifier) 1467647677 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Tamara Marie Dougherty is geographically located?
The Tamara Marie Dougherty is physically situated at the following location: 400 W River Dr, West Bend, WI, 530901567.
What is the area of specialization for Tamara Marie Dougherty, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Tamara Marie Dougherty is Addiction (substance Use Disorder), and the corresponding taxonomy code that categorizes this area of expertise is 101Ya0400X.
When did Tamara Marie Dougherty receive its 1467647677 assignment?
The Tamara Marie Dougherty was assigned its 1467647677 on 2007-09-11, which is the date when this unique identifier was issued to the organization.
As of what date was the information regarding Tamara Marie Dougherty, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Tamara Marie Dougherty, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2009-12-28.