Provider Demographics
NPI:1760748412
Name:BLAIR, ANNE HUTCHINS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:HUTCHINS
Last Name:BLAIR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2362 N WHISPERING PINES WAY
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-7662
Mailing Address - Country:US
Mailing Address - Phone:928-853-2219
Mailing Address - Fax:
Practice Address - Street 1:2717 N STEVES BLVD
Practice Address - Street 2:SUITE 11
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3959
Practice Address - Country:US
Practice Address - Phone:928-526-2968
Practice Address - Fax:928-526-0708
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-21071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical