Provider Demographics
NPI:1417221474
Name:LABBE POISSON, KIMBERLY A (PHD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:A
Last Name:LABBE POISSON
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CHERYL DEE AVE
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ME
Mailing Address - Zip Code:04250-6056
Mailing Address - Country:US
Mailing Address - Phone:207-576-3242
Mailing Address - Fax:
Practice Address - Street 1:800 CENTER ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6404
Practice Address - Country:US
Practice Address - Phone:207-782-2726
Practice Address - Fax:207-333-3501
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1123103TS0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPS1123OtherSTATE OF MAINE