Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PY 8120 | FL |
N | 103TC0700X | Clinical Psychologist | PY 8120 | FL |
Y | 103G00000X | Clinical Psychologist | PY8120 | FL |
Y | 103TC0700X | Clinical Psychologist | PY8120 | FL |
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 102L00000X | Psychologist | PY8120 | FL |
N | 103T00000X | Psychologist | PY8120 | FL |
N | 103G00000X | Clinical Psychologist | 8120 | FL |
N | 103TC0700X | Clinical Psychologist | 8120 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY8120 | FL |
N | 103TF0200X | Forensic Psychologist | PY8120 | FL |
N | 103TM1800X | Intellectual & Developmental Disabilities | PY8120 | FL |
NPI | 1124262654 |
---|---|
Provider Name | Dr. Lamar J Ingulli |
First Address | Tampa, FL 33609-4050 |
Second Address | Tampa, FL 33609-4050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2009 |
Last Update Date | 25/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007293800 | (05) | FL |
020601000 | (05) | FL |
FC953W | (02) | FL |