| Doctor Name: | MS. KIMBERLY ANN LEO |
| NPI Number: | 1215234851 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC-C |
| License Number: | XL3766 |
| Business Practice Address: | 78 Madison Ave Community Health And Counseling Services Skowhegan, ME - 04976 |
| Business Phone Number: | 2078584860 |
| Business Fax Number: | 2078584864 |
| Mailing Address: | 78 Madison Ave, Community Health And Counseling Services SKOWHEGAN |
| State: | ME |
| Postal Code: | 04976 |
| Phone Number: | 2078584860 |
| Fax Number: | 2078584864 |
| NPI Enumeration Date: | 02/17/2011 |
| NPI Last Update Date: | 02/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | XL3766 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |