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Organization
TOFBC, LLC
Active
Organization
TOFBC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKY LYNN GLASS L.C.S.W. (THERAPIST, MEMBER OF TOFBC, LLC)
(636) 561-0268
Entity
Organization
Contact information
Practice address
1000 LAKE SAINT LOUIS BLVD, SUITE 261, LAKE SAINT LOUIS, MO 63367-1340
(636) 561-0268
(636) 625-1580
Mailing address
1000 LAKE SAINT LOUIS BLVD, SUITE 261, LAKE SAINT LOUIS, MO 63367-1340
(636) 561-0268
(636) 625-1580
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001020554
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152189
ANTHEM BCBS ID#
MO
05
—
495246514 (46,47,48)
—
MO
Enumeration date
03/05/2007
Last updated
08/22/2020
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