Tasha Lynn Wisdom, LCSW

NPI #1730450156 in Ellington, Missouri

Provider Information

NPI Number: 1730450156
Entity Type: Individual
Name: Tasha Lynn Wisdom, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Jan 17, 2012
Last Updated: Oct 30, 2023

Practice Location

Address: 315 E WALNUT ST
City: Ellington
State: Missouri
ZIP Code: 63638
Phone: (573) 663-2644

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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