Provider Demographics
NPI:1053140137
Name:STEINBRUEGGE, CAMERON GAGE (RBT)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:GAGE
Last Name:STEINBRUEGGE
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-8662
Mailing Address - Country:US
Mailing Address - Phone:636-345-3978
Mailing Address - Fax:
Practice Address - Street 1:11780 BORMAN DR STE 400
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4135
Practice Address - Country:US
Practice Address - Phone:636-345-3978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORBT-24-365381106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician