Individual
MRS. JACKIE C BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
146 SCHOOL BUS LANE, SNOWFLAKE, AZ 85937
(928) 536-4156
Mailing address
177 E MEADOWLARK, SNOWFLAKE, AZ 85937-5116
(928) 243-1250
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
86020236
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86020236
—
AZ
Enumeration date
01/14/2008
Last updated
01/14/2008
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