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1134400369
JON D. GALLAGHER
WATERVILLE, ME
NPI
1134400369
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ME LC4988)
Enumeration Date
2011-09-01
Last Update Date
2011-09-01
Business Address
-- JON D. GALLAGHER LADC
67 EUSTIS PKWY
WATERVILLE, ME 04901-5173
Phone number: 207-873-2136
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Mailing Address
-- JON D. GALLAGHER LADC
19 MAPLE ST
AUGUSTA, ME 04330-4705
Phone number: 207-458-7780
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