Healthcare Provider Details

I. General information

NPI: 1861389900
Provider Name (Legal Business Name): YULDUZ IBRAGIM CT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10861 YANKEE ST
DAYTON OH
45458-3574
US

IV. Provider business mailing address

10290 ALLIANCE RD
BLUE ASH OH
45242-4710
US

V. Phone/Fax

Practice location:
  • Phone: 937-619-0800
  • Fax:
Mailing address:
  • Phone: 888-830-0347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2506897-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: