Individual
SUZANNE BLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 HARBISON WAY, COLUMBIA, SC 29212-3402
(803) 681-0816
Mailing address
957 HICKORY STICK DR, FORT MILL, SC 29715-6931
(803) 389-2463
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-31188
SC
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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