Healthcare Provider Details

I. General information

NPI: 1114570967
Provider Name (Legal Business Name): KANDE KOOGLE MILANO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8945 BROOKSIDE AVE STE 101
WEST CHESTER OH
45069-7123
US

IV. Provider business mailing address

8945 BROOKSIDE AVE STE 101
WEST CHESTER OH
45069-7123
US

V. Phone/Fax

Practice location:
  • Phone: 513-926-1316
  • Fax:
Mailing address:
  • Phone: 513-926-1316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2305383
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: