Provider Demographics
NPI:1265665061
Name:TANKSLEY, ROBERT (MA,ATR-BC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:TANKSLEY
Suffix:
Gender:M
Credentials:MA,ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S 7TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6932
Mailing Address - Country:US
Mailing Address - Phone:702-668-4637
Mailing Address - Fax:702-668-4680
Practice Address - Street 1:720 S 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6932
Practice Address - Country:US
Practice Address - Phone:702-668-4637
Practice Address - Fax:702-668-4680
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator