Blain, Susan W

Blain, Susan W is an individual health care provider with primary practice located at 6651 Chippewa Ste 223, St Louis MO 63109-2531. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Blain, Susan W can be contacted via phone (314) 644-2395.

Contact Information

Primary practice address
6651 Chippewa Ste 223 St Louis MO 63109-2531
Phone: (314) 644-2395
Fax: (314) 644-5917
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1831112861
LBN Legal business name Blain, Susan W
Credentials PSY D
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831112861 NPPES
Other S21684 MARCY HMO
Other 3894 MARCY HMO
Other 6156413 MARCY HMO

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