Provider Demographics
NPI:1134541642
Name:SKIRA, CYNTHIA
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:SKIRA
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 1:5802 GOLDEN OAK CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-4409
Mailing Address - Country:US
Mailing Address - Phone:937-233-1316
Mailing Address - Fax:
Practice Address - Street 1:1407 E 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-1818
Practice Address - Country:US
Practice Address - Phone:937-223-3154
Practice Address - Fax:937-223-3229
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.003780101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional