Provider Demographics
NPI:1023872868
Name:IAGULLI INSIGHTS THERAPY, PLLC
Entity type:Organization
Organization Name:IAGULLI INSIGHTS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:IAGULLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-638-3929
Mailing Address - Street 1:8124 HENDRICKS DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4901
Mailing Address - Country:US
Mailing Address - Phone:512-638-3929
Mailing Address - Fax:
Practice Address - Street 1:8124 HENDRICKS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4901
Practice Address - Country:US
Practice Address - Phone:512-638-3929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health