Provider Demographics
NPI:1871927442
Name:TANAKA, AKIHO (PHD)
Entity type:Individual
Prefix:DR
First Name:AKIHO
Middle Name:
Last Name:TANAKA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 VIRGINIA DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-2526
Mailing Address - Country:US
Mailing Address - Phone:407-335-8211
Mailing Address - Fax:
Practice Address - Street 1:1011 VIRGINIA DR STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-2526
Practice Address - Country:US
Practice Address - Phone:407-335-8211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8836103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical