Individual
DR. TAMMY ANNE MARTIELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
425 N NEW BALLAS RD STE 290, CREVE COEUR, MO 63141-6852
(314) 324-3800
(314) 260-7676
Mailing address
425 N NEW BALLAS RD STE 290, CREVE COEUR, MO 63141-6852
(314) 324-3800
(314) 260-7676
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2009010486
MO
103TC0700X
Clinical Psychologist
2009010486
MO
Other
Enumeration date
09/28/2007
Last updated
06/30/2020
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