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Individual

MARIANNE TETTLEBAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
X
Credential
LCSW

Contact information

Practice address
7400 GAYOLA PL, SAINT LOUIS, MO 63143-2006
(501) 772-7164
Mailing address
7400 GAYOLA PL, SAINT LOUIS, MO 63143-2006
(501) 772-7164

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2025017404
MO

Other

Enumeration date
08/22/2025
Last updated
08/31/2025
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