Healthcare Provider Details

I. General information

NPI: 1548988165
Provider Name (Legal Business Name): BLAIRE MCCREARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3203 E TERRA ALTA BLVD # B
TUCSON AZ
85716-4539
US

IV. Provider business mailing address

3203 E TERRA ALTA BLVD # B
TUCSON AZ
85716-4539
US

V. Phone/Fax

Practice location:
  • Phone: 760-533-8149
  • Fax:
Mailing address:
  • Phone: 253-353-2739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT-16576
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF61569883
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: