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Individual

CHRISTOPHER COOSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC,CCS

Contact information

Practice address
142 HIGH ST, SUITE 416, PORTLAND, ME 04101-2851
(207) 780-8999
(207) 615-0018
Mailing address
142 HIGH ST, SUITE 416, PORTLAND, ME 04101-2851
(207) 780-8999
(207) 615-0018

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCS2830
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC1188
ME

Other

Enumeration date
08/06/2009
Last updated
08/06/2009
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