Healthcare Provider Details

I. General information

NPI: 1629985346
Provider Name (Legal Business Name): MRS. BRITTNEY MICHELLE TINGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20114 E PENNSYLVANIA AVE
DUNNELLON FL
34432-6033
US

IV. Provider business mailing address

1813 E WESTGATE LN
HERNANDO FL
34442-4575
US

V. Phone/Fax

Practice location:
  • Phone: 205-239-8529
  • Fax:
Mailing address:
  • Phone: 205-239-8529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1926
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: