Individual
JASON GRUNDSTROM-WHITNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC/LSW
Contact information
Practice address
250 ARSENAL ST, AUGUSTA, ME 04330-5742
(207) 624-3999
Mailing address
37 MIKES RD, MONMOUTH, ME 04259-7226
(207) 624-3999
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC3358
ME
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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