Individual
DR. PHYLLIS A BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPCC
Contact information
Practice address
HWY 554 GATE 110, ABIQUIU, NM 87510-0631
(505) 685-4052
Mailing address
132 ROMERO ST, #7, SANTA FE, NM 87501-7302
(505) 820-7515
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NM LPCC 2380
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N776
BLUE CROSS BLUE SHIELD
NM
Enumeration date
11/12/2006
Last updated
07/17/2007
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