Provider Demographics
NPI:1245353804
Name:BLAIR-NEFF, TENILLE RENE (MS, LCAT, ATR-BC)
Entity type:Individual
Prefix:MS
First Name:TENILLE
Middle Name:RENE
Last Name:BLAIR-NEFF
Suffix:
Gender:F
Credentials:MS, LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 STATE HIGHWAY 248 STE 3
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-7740
Mailing Address - Country:US
Mailing Address - Phone:417-334-3685
Mailing Address - Fax:
Practice Address - Street 1:576 STATE HIGHWAY 248 STE 3
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616
Practice Address - Country:US
Practice Address - Phone:417-334-3685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1510112101YP2500X
NY000340221700000X
MO2017004077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist