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
Phone: (414) 962-4048
Fax: (414) 962-4052
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730107228 | NPPES |
| Wisconsin | MEDICAID | 39125400 |
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