Healthcare Provider Details

I. General information

NPI: 1437034907
Provider Name (Legal Business Name): HARRIET TIKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 STATE ROUTE 159
CHILLICOTHEE OH
45601-8620
US

IV. Provider business mailing address

PO BOX 6179
CHILLICOTHEE OH
45601-6179
US

V. Phone/Fax

Practice location:
  • Phone: 740-775-1260
  • Fax:
Mailing address:
  • Phone: 740-775-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2506779-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: