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Individual
TRAVIS JAMAL BLAIR
Active
Individual
TRAVIS JAMAL BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
122092
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/02/2016
Last updated
04/22/2024
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