Southwestern Maine Clinical Assoc PA

NPI #1265405385 in Gorham, Maine

Provider Information

NPI Number: 1265405385
Entity Type: Organization
Organization Name: Southwestern Maine Clinical Assoc PA
Primary Specialty: Psychologist
Enumeration Date: Feb 9, 2006
Last Updated: Apr 24, 2008

Practice Location

Address: 20 MECHANIC ST
City: Gorham
State: Maine
ZIP Code: 04038
Phone: (207) 839-2587

Authorized Official

Name: DR. KERRY E KIMBALL, EDD
Title: CEO
Phone: (207) 839-2587

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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