Individual
MRS. SUSAN B. BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMFT, CCDP
Contact information
Practice address
349 MAIN ST STE 1, GAITHERSBURG, MD 20878-5780
(240) 273-4645
(301) 865-3264
Mailing address
PO BOX 3628, GAITHERSBURG, MD 20885-3628
(240) 273-4645
(301) 865-3264
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
000148
DC
106H00000X
Marriage & Family Therapist
0717001254
VA
106H00000X
Marriage & Family Therapist
3
WV
106H00000X
Marriage & Family Therapist
Primary
LCM463
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235942
—
CT
05
—
024905300
—
DC
Enumeration date
11/22/2006
Last updated
04/23/2015
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