Provider Demographics
NPI:1417213356
Name:ALIKI, TANYA MARIE (LMFT, CSAC)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:MARIE
Last Name:ALIKI
Suffix:
Gender:F
Credentials:LMFT, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 VENESSA DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-7267
Mailing Address - Country:US
Mailing Address - Phone:931-552-7863
Mailing Address - Fax:
Practice Address - Street 1:22ND INDIANNA AVE
Practice Address - Street 2:BLG 2516
Practice Address - City:FORT CAMBPELL
Practice Address - State:KY
Practice Address - Zip Code:42223
Practice Address - Country:US
Practice Address - Phone:270-798-4269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT 302106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist