Provider Demographics
NPI:1477804516
Name:IGAH, FLORA O (PHD, CRC, CDCA)
Entity Type:Individual
Prefix:DR
First Name:FLORA
Middle Name:O
Last Name:IGAH
Suffix:
Gender:F
Credentials:PHD, CRC, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 STEINER AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3813
Mailing Address - Country:US
Mailing Address - Phone:937-754-0528
Mailing Address - Fax:
Practice Address - Street 1:1443 STEINER AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3813
Practice Address - Country:US
Practice Address - Phone:937-754-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00114274101Y00000X
OH080829101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor