Provider Demographics
NPI:1497598056
Name:ALKHALIQ, TANYA AKILAH
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:AKILAH
Last Name:ALKHALIQ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 TIMBERCROFT LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5386
Mailing Address - Country:US
Mailing Address - Phone:910-973-3205
Mailing Address - Fax:
Practice Address - Street 1:6830 TIMBERCROFT LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-5386
Practice Address - Country:US
Practice Address - Phone:910-973-3205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist