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General NPI Number Information
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NPI Number | 1265642490
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Entity Type | Organization
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Legal Business Name | BLAIR'S COUNSELING SERVICE
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2652 EGRET LN
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City | TALLAHASSEE
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State | FL
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Zip | 32308-0542
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Country | US
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Telephone | 850-297-2190
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12697
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City | TALLAHASSEE
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State | FL
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Zip | 32317-2697
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Country | US
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Telephone | 850-297-2190
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Fax | 850-385-6598
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MAUDINE BLAIR
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Credential | PH.D., FAPA, CGP,CRS
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Telephone | 850-297-2190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT 233
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License Number State | FL
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