JACKSON COOPER

SACO, ME
NPI1215123047
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ME  LC6541)
Enumeration Date2007-09-14
Last Update Date2007-09-14
Business Address
-- JACKSON COOPER LCSW
50 MOODY ST
SACO, ME 04072-1536
Phone number: 800-434-3000
Mailing Address
-- JACKSON COOPER LCSW
33 OBRION ST
PORTLAND, ME 04101-4411
Phone number:
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