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Individual

MRS. DEBRA RAYE KINNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
23 FIELDSTONE DRIVE, BANGOR, ME 04401
(207) 947-3176
(207) 945-9924
Mailing address
23 FIELDSTONE DRIVE, BANGOR, ME 04401
(207) 947-3176
(207) 945-9924

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
02/27/2007
Last updated
07/08/2007
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