Individual
AMANDA E BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
112 INNWOOD DR, COVINGTON, LA 70433-9134
(225) 436-2011
Mailing address
916 AGNES ST, MANDEVILLE, LA 70448-6502
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11589
LA
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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