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1841722378
JASON WILLIAM NICKERSON
PORTLAND, ME
NPI
1841722378
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ME cac5536)
Enumeration Date
2017-04-03
Last Update Date
2017-04-03
Business Address
-- JASON WILLIAM NICKERSON CADC
72 AUBURN ST
PORTLAND, ME 04103-2104
Phone number: 207-245-1800
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Mailing Address
-- JASON WILLIAM NICKERSON CADC
72 AUBURN ST
PORTLAND, ME 04103-2104
Phone number: 207-245-1800
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