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General NPI Number Information
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NPI Number | 1962757443
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Entity Type | Organization
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Legal Business Name | BLAIR MARRIAGE AND FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 07/20/2012
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 2547 W SHAW AVE SUITE 117
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City | FRESNO
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State | CA
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Zip | 93711-3321
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Country | US
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Telephone | 559-412-7799
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Fax |
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Provider Business Mailing Address
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Address Line | 2547 W SHAW AVE SUITE 117
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City | FRESNO
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State | CA
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Zip | 93711-3321
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Country | US
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Telephone | 559-412-7799
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VINCENT BLAIR
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Credential | LMFT
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Telephone | 559-412-7799
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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 | MFC 51015
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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