Male or Other

Jonathan Cross

Addiction (Substance Use Disorder) Counselor in Portland, ME(View on Map)

Full Name

Jonathan Cross

NPI Number

1851916886

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/16/2020

Specialties

(Taxonomies)

Code

101YA0400X

Primary Taxonomy

Yes

Licenses

State

Maine
Maine

License Number

LC6907
CAC6296

Contact
Information

Purpose

Mailing
Location

Address

49 MONTROSE AVE APT 3
49 MONTROSE AVE APT 3

City

Portland
Portland

State

ME
ME

Postal Code

04103-2442
04103-2442

Country

US
US

Telephone Number

N/A
(207) 400-5122

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/19/2020

Provider Address

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