Provider Demographics
NPI:1386188308
Name:ALAIN, TABATA C (MFT)
Entity Type:Individual
Prefix:
First Name:TABATA
Middle Name:C
Last Name:ALAIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:TABATA
Other - Middle Name:C
Other - Last Name:MARLOWE, WHITE, ALAIN, FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:I-MFT
Mailing Address - Street 1:7031 CORPORATE WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4262
Mailing Address - Country:US
Mailing Address - Phone:937-619-9089
Mailing Address - Fax:937-328-7257
Practice Address - Street 1:7031 CORPORATE WAY STE 103
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4262
Practice Address - Country:US
Practice Address - Phone:937-619-9089
Practice Address - Fax:937-328-7257
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-09
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.1500026106H00000X
OHF.2300368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist