Individual
KERRY KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
E.D.D
Contact information
Practice address
20 MECHANIC ST, GORHAM, ME 04038-1560
(207) 839-2587
(207) 839-6469
Mailing address
PO BOX 757, GORHAM, ME 04038-0757
(207) 839-2587
(207) 839-6469
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS574
ME
Other
Enumeration date
01/07/2008
Last updated
04/17/2008
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