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General NPI Number Information
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NPI Number | 1972577484
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Entity Type | Individual
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Provider Name | SYDNEY P BLAIR LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 228 17TH AVE NW CENTER FOR MENTAL HEALTH/CMR HIGH SCHOOL
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City | GREAT FALLS
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State | MT
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Zip | 59404-1807
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Country | US
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Telephone | 406-268-6126
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 FOX FARM RD
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City | GREAT FALLS
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State | MT
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Zip | 59404-6411
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Country | US
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Telephone | 406-761-4995
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 389 LCSW
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License Number State | MT
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