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NPI Code Detail

MEDICARE: JONATHAN BLAIR

MEDICARE: JONATHAN BLAIR
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1558041285
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN BLAIR
Provider Business Mailing Address
First Line : 905 JEFFERSON AVE STE 300
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-4740
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 905 JEFFERSON AVE STE 300
Second Line :
City : SAINT PAUL
State : MN
Zip : 55102-4740
Country : US
Telephone Number : 507-720-4349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2023
Last Update Date : 07/18/2023

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Directions to “ JONATHAN BLAIR ” Practice Location

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