Doctor Name: | ALYSON SHEA BLAIR |
NPI Number: | 1053520163 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC, LPC |
License Number: | 931 |
Business Practice Address: | 501 N Mustang Rd Mustang, OK - 730647048 |
Business Phone Number: | 4052038285 |
Business Fax Number: | |
Mailing Address: | 415 Winding Ln, EDMOND |
State: | OK |
Postal Code: | 730035129 |
Phone Number: | 4052038285 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 08/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 931 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |