Provider Demographics
NPI:1942911383
Name:GIGO, AWA
Entity Type:Individual
Prefix:
First Name:AWA
Middle Name:
Last Name:GIGO
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 1:6505 WINCHESTER HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9475
Mailing Address - Country:US
Mailing Address - Phone:614-817-8355
Mailing Address - Fax:
Practice Address - Street 1:6505 WINCHESTER HIGHLANDS DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9475
Practice Address - Country:US
Practice Address - Phone:614-817-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services