Individual
MR. BLAIR MICHAEL ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2900 BRISTOL ST, J-204, COSTA MESA, CA 92626-5981
(714) 510-6104
Mailing address
137 S LOS TIMBRES ST, ORANGE, CA 92869-4200
(714) 510-6104
(714) 538-6103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS14938
CA
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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