Provider Demographics
NPI:1629396221
Name:GULLI, DOMINICK (PSYD, LMHC, NCC)
Entity Type:Individual
Prefix:DR
First Name:DOMINICK
Middle Name:
Last Name:GULLI
Suffix:
Gender:M
Credentials:PSYD, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S HOOVER BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3540
Mailing Address - Country:US
Mailing Address - Phone:813-716-8936
Mailing Address - Fax:
Practice Address - Street 1:1205 WINDHORST RIDGE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-3122
Practice Address - Country:US
Practice Address - Phone:813-716-8936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4337101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health