Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PY 7353 | FL |
N | 103TC0700X | Clinical Psychologist | PY 7353 | FL |
Y | 102L00000X | Psychologist | PY7353 | FL |
Y | 103T00000X | Psychologist | PY7353 | FL |
N | 103G00000X | Clinical Psychologist | PY 7353 | FL |
N | 103TC0700X | Clinical Psychologist | PY 7353 | FL |
N | 103TH0100X | Health Service | PY 7353 | FL |
NPI | 1245401504 |
---|---|
Provider Name | Dr. Tamara Duckworth Warner |
First Address | Gainesville, FL 32606-3813 |
Second Address | Gainesville, FL 32606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2008 |
Last Update Date | 13/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
152JV | BCBS NC (01) | |
52064 | NATIONAL REGISTER OF HEALTH PROVIDERS IN PSYCHOLOGY (01) | |
593L3 | BCBS OF FLORIDA (01) | FL |
6001156 | (05) | NC |