Provider Demographics
NPI:1154468783
Name:BLAIR, MAUREEN ELIZABETH (BA)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:BLAIR
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11931 OAKMONT ST
Mailing Address - Street 2:# 1615
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-5749
Mailing Address - Country:US
Mailing Address - Phone:805-284-3933
Mailing Address - Fax:
Practice Address - Street 1:11931 OAKMONT ST
Practice Address - Street 2:# 1615
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-5749
Practice Address - Country:US
Practice Address - Phone:805-284-3933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health