Blair, Kelly Lane

Blair, Kelly Lane is an individual health care provider with primary practice located at 708 W Forest Ave , Jackson TN 38301-3901. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Rehabilitation. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Blair, Kelly Lane can be contacted via phone (731) 425-4930.

Contact Information

Primary practice address
708 W Forest Ave Jackson TN 38301-3901
Phone: (731) 425-4930
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1706 Tennessee
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X 1706 Tennessee

Profile Details

NPI number 1891711131
LBN Legal business name Blair, Kelly Lane
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Jul 31st, 2009 - about 15 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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