Provider Demographics
NPI:1932759701
Name:BRENKERT, APRIL MARIE
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:MARIE
Last Name:BRENKERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 MORRELL RAY RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44402-9781
Mailing Address - Country:US
Mailing Address - Phone:330-673-1347
Mailing Address - Fax:330-678-3677
Practice Address - Street 1:103 W MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481-1017
Practice Address - Country:US
Practice Address - Phone:330-394-8831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health