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NPI Code Detail

MEDICARE: ROSE MARIE BLAIR LPC

MEDICARE: ROSE MARIE BLAIR LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2009024845MO

General Provider Information

NPI Number : 1538477740
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE MARIE BLAIR LPC
Provider Business Mailing Address
First Line : 203 N GRAND ST
Second Line :
City : SALEM
State : MO
Zip : 65560-1344
Country : US
Telephone Number : 573-729-4103
Fax Number :
Provider Business Practice Location Address
First Line : 203 N GRAND ST
Second Line :
City : SALEM
State : MO
Zip : 65560-1344
Country : US
Telephone Number : 573-729-4103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2010
Last Update Date : 03/17/2018

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Directions to “ ROSE MARIE BLAIR LPC” Practice Location

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