Individual
BLAIR SUPPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1607 3RD ST, BEAVER, PA 15009-2420
(724) 728-8400
(724) 728-7666
Mailing address
1607 3RD ST, BEAVER, PA 15009-2420
(724) 728-8400
(724) 728-7666
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC008184
PA
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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