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General NPI Number Information
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NPI Number | 1801440664
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Entity Type | Individual
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Provider Name | TAMMY TELLEZ LPC
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 9666 OLIVE BLVD STE 510
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City | OLIVETTE
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State | MO
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Zip | 63132-3026
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Country | US
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Telephone | 618-570-7745
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Fax | 314-804-1269
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Provider Business Mailing Address
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Address Line | 9378 OLIVE BLVD STE 307
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City | OLIVETTE
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State | MO
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Zip | 63132-3224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1780143950
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2016004560
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License Number State | MO
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