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General NPI Number Information
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NPI Number | 1972640985
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Entity Type | Individual
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Provider Name | TAMMY L TOMBROFF LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 3013 1ST ST
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-2268
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Country | US
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Telephone | 904-321-6049
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Fax |
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Provider Business Mailing Address
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Address Line | 3013 FIRST STREET
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City | ST AUGUSTINE
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State | FL
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Zip | 32084
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Country | US
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Telephone | 904-829-3097
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW7218
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7218
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License Number State | FL
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