Individual
TANASHA BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED
Contact information
Practice address
1315 RIVER ST APT F86, VALDOSTA, GA 31601-5287
(229) 630-7689
Mailing address
1315 RIVER ST APT F86, VALDOSTA, GA 31601-5287
(229) 630-7689
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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