JASON WILLIAM NICKERSON

PORTLAND, ME
NPI1841722378
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: ME  CAC5536)
Enumeration Date2017-04-03
Last Update Date2017-04-03
Business Address
JASON WILLIAM NICKERSON CADC
72 AUBURN ST
PORTLAND, ME 04103-2104
Phone number: 207-245-1800
Mailing Address
JASON WILLIAM NICKERSON CADC
72 AUBURN ST
PORTLAND, ME 04103-2104
Phone number: 207-245-1800
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