Blair, Elizabeth Marie

Blair, Elizabeth Marie is an individual health care provider with primary practice located at 5900 N Port Washington Rd Ste 230, Glendale WI 53217. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Blair, Elizabeth Marie can be contacted via phone (414) 962-4048.

Contact Information

Primary practice address
5900 N Port Washington Rd Ste 230 Glendale WI 53217
Fax: (414) 962-4052
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2121057 Wisconsin

Profile Details

NPI number 1730107228
LBN Legal business name Blair, Elizabeth Marie
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Nov 3rd, 2016 - about 10 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 1730107228 NPPES
Wisconsin MEDICAID 39125400

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