Individual
TATYANA DOMINIQUE MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 UNIVERSITY AVE, SUITE 2B, FAIRBANKS, AK 99709
(907) 371-2240
(907) 371-2241
Mailing address
600 UNIVERSITY AVE, SUITE 2B, FAIRBANKS, AK 99709
(907) 371-2240
(907) 474-3621
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
06/12/2024
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