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General NPI Number Information
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NPI Number | 1669902581
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Entity Type | Individual
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Provider Name | SIMARA N BLAIR LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9171 HAROLD DR
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City | SAINT LOUIS
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State | MO
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Zip | 63134-3565
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Country | US
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Telephone | 314-484-7709
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Fax |
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Provider Business Mailing Address
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Address Line | 9171 HAROLD DR
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City | SAINT LOUIS
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State | MO
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Zip | 63134-3565
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Country | US
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Telephone | 314-484-7709
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2014031711
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License Number State | MO
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