GAVIN BLACK

PORTLAND, ME
NPI1588503346
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ME  CAC9381)
Enumeration Date2026-03-26
Last Update Date2026-03-26
Business Address
GAVIN BLACK
17 BISHOP ST
PORTLAND, ME 04103-2659
Phone number: 207-835-0488
Mailing Address
GAVIN BLACK
9 ROMASCO LN UNIT 2
PORTLAND, ME 04101-3699
Phone number:
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