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Individual

KIM KNOWLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
15 PLEASANT HILL RD STE 204, SCARBOROUGH, ME 04074-9688
(207) 799-6166
(207) 885-1062
Mailing address
PO BOX 2121, SOUTH PORTLAND, ME 04116-2121
(207) 767-1260
(207) 767-1261

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS977
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MM793002
PTAN
Enumeration date
04/11/2006
Last updated
07/21/2022
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