Individual
MS. KIMBERLY JO COVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15 MELLEN ST, PORTLAND, ME 04101-2109
(207) 772-6111
Mailing address
15 MELLEN ST, PORTLAND, ME 04101-2109
(207) 772-6111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC6057
ME
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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