Provider Demographics
NPI:1326669656
Name:GREENE, S KIMBLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:S KIMBLE
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W POWNAL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04097-6818
Mailing Address - Country:US
Mailing Address - Phone:860-316-7530
Mailing Address - Fax:
Practice Address - Street 1:50 W POWNAL RD
Practice Address - Street 2:
Practice Address - City:NORTH YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04097-6818
Practice Address - Country:US
Practice Address - Phone:860-316-7530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health