Provider Demographics
NPI:1992305106
Name:KINZLE, MEAGHAN LEIGH (LMFT)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:LEIGH
Last Name:KINZLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28973 RIVER OAKS LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-6853
Mailing Address - Country:US
Mailing Address - Phone:909-727-1864
Mailing Address - Fax:
Practice Address - Street 1:104 E OLIVE AVE STE 201
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5255
Practice Address - Country:US
Practice Address - Phone:909-727-1864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health