Individual
GLENN ROBERT GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC, MHRT-CSP
Contact information
Practice address
150 CONGRESS ST, RUMFORD, ME 04276-2035
(207) 357-1751
Mailing address
150 CONGRESS ST, RUMFORD, ME 04276-2035
(207) 357-1751
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC8262
ME
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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