Provider Demographics
NPI:1558521120
Name:SCOTT, TAMARA SUSAN (MSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:SUSAN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:SUSAN
Other - Last Name:DEWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:415 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-4002
Mailing Address - Country:US
Mailing Address - Phone:636-397-6070
Mailing Address - Fax:
Practice Address - Street 1:415 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-4002
Practice Address - Country:US
Practice Address - Phone:636-397-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker