Provider Demographics
NPI:1336413194
Name:TIAI, EMOSI DANNY
Entity Type:Individual
Prefix:
First Name:EMOSI
Middle Name:DANNY
Last Name:TIAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 EIDE ST APT 9
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2631
Mailing Address - Country:US
Mailing Address - Phone:907-227-2423
Mailing Address - Fax:
Practice Address - Street 1:1104 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2759
Practice Address - Country:US
Practice Address - Phone:907-375-3200
Practice Address - Fax:907-375-3292
Is Sole Proprietor?:No
Enumeration Date:2012-02-25
Last Update Date:2012-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker