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Individual

NICHOLE BLAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
110 CINDERELLA RD, WILLIAMSON, WV 25661-1199
(304) 235-3333
Mailing address
110 CINDERELLA RD, WILLIAMSON, WV 25661-1199
(304) 235-3333

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
R7A130500116
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215106265
WV
Enumeration date
09/27/2022
Last updated
09/27/2022
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