Provider Demographics
NPI:1083884241
Name:MAKI, ALICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:MAKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 CAPITAL CIR NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-8401
Mailing Address - Country:US
Mailing Address - Phone:850-671-4600
Mailing Address - Fax:850-878-2863
Practice Address - Street 1:1965 CAPITAL CIR NE
Practice Address - Street 2:SUITE 102
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-8401
Practice Address - Country:US
Practice Address - Phone:850-671-4600
Practice Address - Fax:850-878-2863
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7527103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000981400Medicaid
FLPY7527OtherFL LICENSE