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General NPI Number Information
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NPI Number | 1811322811
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Entity Type | Organization
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Legal Business Name | AKIHO TANAKA, PHD, LLC
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 1011 VIRGINIA DR STE 102
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City | ORLANDO
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State | FL
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Zip | 32803-2526
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Country | US
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Telephone | 407-335-8211
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 VIRGINIA DR STE 102
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City | ORLANDO
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State | FL
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Zip | 32803-2526
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Country | US
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Telephone | 407-335-8211
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. AKIHO TANAKA
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Credential | PH.D.
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Telephone | 407-335-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY8836
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License Number State | FL
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