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Individual

DR. TARA LIVENGOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
1315 W 17TH ST UNIT 15034, PANAMA CITY, FL 32406-7702
(850) 276-6401
(850) 792-6916
Mailing address
1315 W 17TH ST UNIT 15034, PANAMA CITY, FL 32406-7702
(850) 276-6401
(850) 792-6916

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
39532
TX
103TC0700X
Clinical Psychologist
Primary
PY10222
FL

Other

Enumeration date
08/17/2018
Last updated
02/12/2025
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