JONATHAN D SANDAU

BANGOR, ME
NPI1104277201
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ME  CAC6099)
Enumeration Date2016-06-29
Last Update Date2016-06-29
Business Address
-- JONATHAN D SANDAU
557 HAMMOND ST
BANGOR, ME 04401-4511
Phone number: 207-973-0505
Mailing Address
-- JONATHAN D SANDAU
511 WING RD
HERMON, ME 04401-0422
Phone number: 207-659-1577
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