Individual
NEDRA LYNN TANKSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 268-5700
Mailing address
3648 FLAD AVE, SAINT LOUIS, MO 63110-4022
(636) 236-1565
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001014357
MO
Other
Enumeration date
12/03/2020
Last updated
12/23/2022
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