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General NPI Number Information
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NPI Number | 1467842096
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE BLAIR MFTI
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Gender | Female
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 14600 SHERMAN WAY SUITE 100D
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City | VAN NUYS
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State | CA
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Zip | 91405-2283
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Country | US
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Telephone | 818-374-6901
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Fax |
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Provider Business Mailing Address
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Address Line | 1914 N FAIRVIEW ST
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City | BURBANK
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State | CA
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Zip | 91505-1211
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Country | US
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Telephone | 818-653-5266
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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