Provider Demographics
NPI:1518288059
Name:RAWLINS, BLAIR (LPC, LADC)
Entity Type:Individual
Prefix:MS
First Name:BLAIR
Middle Name:
Last Name:RAWLINS
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 E 17TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-7202
Mailing Address - Country:US
Mailing Address - Phone:918-902-9958
Mailing Address - Fax:
Practice Address - Street 1:1518 E 17TH PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-7202
Practice Address - Country:US
Practice Address - Phone:918-902-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional