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Individual

ELIZABETH MAE BLEDSOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4251 FOREST PARK AVE, SAINT LOUIS, MO 63108-2810
(314) 471-8220
(314) 531-9731
Mailing address
4251 FOREST PARK AVE, SAINT LOUIS, MO 63108-2810
(314) 471-8220
(314) 531-9731

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
088003
NY
1041C0700X
Clinical Social Worker
Primary
2022012043
MO
1041C0700X
Clinical Social Worker
34007972A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2022012043
MO LCSW LICENSE
MO
Enumeration date
11/13/2017
Last updated
07/21/2022
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