Individual
MATT MACARTHUR VAN BLAIR
Active
Individual
MATT MACARTHUR VAN BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37368
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205480563
AGNES AVE
—
Enumeration date
03/21/2018
Last updated
01/12/2022
Update your record
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