Lie, Tanesha Michele
Lie, Tanesha Michele is an sole proprietor health care provider with primary practice located at 1051 South Cushman Street , Fairbanks AK 99701. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Lie, Tanesha Michele can be contacted via phone (907) 388-6817.Contact Information
Primary practice address
1051 South Cushman Street
Fairbanks AK 99701
Phone: (907) 388-6817
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X |
Profile Details
| NPI number | 1487321386 |
|---|---|
| LBN Legal business name | Lie, Tanesha Michele |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 27th, 2021 |
| Last updated | Aug 27th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487321386 | NPPES |
| Alaska | MEDICAID | NONE |
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