Provider Demographics
NPI:1467709071
Name:KIMBERLY A. FEENEY, PLLC
Entity Type:Organization
Organization Name:KIMBERLY A. FEENEY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR / PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:207-615-3293
Mailing Address - Street 1:5 RENNIE LANE
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04010-4937
Mailing Address - Country:US
Mailing Address - Phone:207-615-3293
Mailing Address - Fax:
Practice Address - Street 1:5 RENNIE LANE
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:ME
Practice Address - Zip Code:04010-4937
Practice Address - Country:US
Practice Address - Phone:207-615-3293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP918235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty