Provider Demographics
NPI:1679820948
Name:SONS, BLAIR NICOLE (MA,PPS,BCBA)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:NICOLE
Last Name:SONS
Suffix:
Gender:F
Credentials:MA,PPS,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5290 E DWIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-5988
Mailing Address - Country:US
Mailing Address - Phone:559-287-9121
Mailing Address - Fax:
Practice Address - Street 1:1220 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-3595
Practice Address - Country:US
Practice Address - Phone:559-305-7130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-7994103K00000X
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool