Healthcare Provider Details

I. General information

NPI: 1417221474
Provider Name (Legal Business Name): KIMBERLY A LABBE POISSON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CENTER ST
AUBURN ME
04210-6404
US

IV. Provider business mailing address

21 CHERYL DEE AVE
LISBON ME
04250-6056
US

V. Phone/Fax

Practice location:
  • Phone: 207-782-2726
  • Fax: 207-333-3501
Mailing address:
  • Phone: 207-576-3242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS1123
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPS1123
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: