Basic Information
Provider Information
NPI: 1205067329
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KANDIL
FirstName: APRIL
MiddleName: MARTINIA
NamePrefix:  
NameSuffix:  
Credential: MA, PC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FINK
OtherFirstName: APRIL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 4700 ASHWOOD DR STE 200
Address2:  
City: BLUE ASH
State: OH
PostalCode: 452412424
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4700 ASHWOOD DR STE 200
Address2:  
City: BLUE ASH
State: OH
PostalCode: 452412424
CountryCode: US
TelephoneNumber: 5134897100
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2009
LastUpdateDate: 08/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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