Blair, Melissa M.

Blair, Melissa M. is an sole proprietor health care provider with primary practice located at 3005 James Ave S , Minneapolis MN 55408-2533. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Blair, Melissa M. can be contacted via phone (612) 227-2829.

Contact Information

Primary practice address
3005 James Ave S Minneapolis MN 55408-2533
Phone: (612) 227-2829
Fax: (612) 377-7501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X LP3550 Minnesota
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1962570242
LBN Legal business name Blair, Melissa M.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 2nd, 2006
Last updated Nov 10th, 2022 - about 2 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 1962570242 NPPES
Minnesota MEDICAID 040161700
Minnesota Other 6173818
Minnesota Other 117T6NA OR 114T7NA
Minnesota Other 20258-11
Minnesota Other 141774

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