Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 103G00000X | Clinical Psychologist | PY 9479 | FL |
Y | 103TC0700X | Clinical Psychologist | PY 9479 | FL |
NPI | 1013388313 |
---|---|
Provider Name | Tamara Foxworth |
First Address | Tampa, FL 33612-4745 |
Second Address | Tampa, FL 33612-4745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2015 |
Last Update Date | 02/03/2016 |