Provider Demographics
NPI:1902093487
Name:KIECOLT, APRIL MARIE (MFT-TRAINEE)
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:MARIE
Last Name:KIECOLT
Suffix:
Gender:F
Credentials:MFT-TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1167
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92556-1167
Mailing Address - Country:US
Mailing Address - Phone:951-488-9084
Mailing Address - Fax:951-485-8266
Practice Address - Street 1:12730 HEACOCK ST
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3040
Practice Address - Country:US
Practice Address - Phone:951-488-9084
Practice Address - Fax:951-485-8266
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program