Individual
KATHERINE BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
19 COACH LEE HILL BLVD, STATESBORO, GA 30458-4700
(912) 662-6501
Mailing address
108 EASON ST, STATESBORO, GA 30458-0790
(912) 306-0189
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
220532
MA
101YM0800X
Mental Health Counselor
CSW007072
GA
1041C0700X
Clinical Social Worker
Primary
CSW007072
GA
Other
Enumeration date
08/20/2016
Last updated
03/13/2024
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