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Individual

LARRY VAUGHN BLAIR

Active
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Individual

LARRY VAUGHN BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.I.C.S.W.

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10727
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
708390400
MN
Enumeration date
02/17/2010
Last updated
09/25/2024
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