Individual
MANDY SUSANNE KIECKHABEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
411 LAKEWOOD CIR STE C201, COLORADO SPRINGS, CO 80910-2668
(719) 238-8205
Mailing address
411 LAKEWOOD CIR STE C201, COLORADO SPRINGS, CO 80910-2668
(719) 238-8205
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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