Provider Demographics
NPI:1922612811
Name:HAWES, KYMBERLEIGH ANN
Entity Type:Individual
Prefix:
First Name:KYMBERLEIGH
Middle Name:ANN
Last Name:HAWES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 DUNBARTON RD APT 9
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-2565
Mailing Address - Country:US
Mailing Address - Phone:603-340-3266
Mailing Address - Fax:
Practice Address - Street 1:20 MARKET ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1957
Practice Address - Country:US
Practice Address - Phone:855-499-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)