Individual
KIMBERLY M. BLANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
106 GILMAN ST, PORTLAND, ME 04102-3034
(207) 874-1087
(207) 553-9236
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 661-6654
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC1140
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254590099
—
ME
Enumeration date
12/27/2006
Last updated
06/22/2016
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