Individual
ALYSON SHEA BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, LPC
Contact information
Practice address
501 N MUSTANG RD, MUSTANG, OK 73064-7048
(405) 203-8285
Mailing address
415 WINDING LN, EDMOND, OK 73003-5129
(405) 203-8285
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
931
OK
101YP2500X
Professional Counselor
Primary
5072
OK
Other
Enumeration date
05/22/2007
Last updated
08/10/2015
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