Provider Demographics
NPI:1821042284
Name:DELBRUEGGE, TAMMY G (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:G
Last Name:DELBRUEGGE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 SCHUMACHER RD
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-2818
Mailing Address - Country:US
Mailing Address - Phone:363-343-7460
Mailing Address - Fax:
Practice Address - Street 1:2745 HIGH RIDGE BLVD
Practice Address - Street 2:SUITE #13
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2200
Practice Address - Country:US
Practice Address - Phone:636-343-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0058611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical