Provider Demographics
NPI:1124503339
Name:KIONI, FRAYETTE OLIVIA (LMFT, TFCBT, JSOCC)
Entity type:Individual
Prefix:MRS
First Name:FRAYETTE
Middle Name:OLIVIA
Last Name:KIONI
Suffix:
Gender:F
Credentials:LMFT, TFCBT, JSOCC
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 230391
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36123-0391
Mailing Address - Country:US
Mailing Address - Phone:334-219-0339
Mailing Address - Fax:
Practice Address - Street 1:8650 MINNIE BROWN RD.
Practice Address - Street 2:SUITE 221
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7845
Practice Address - Country:US
Practice Address - Phone:334-219-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL469106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1720609936Medicaid