Individual
DR. MELISSA M. BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3005 JAMES AVE S, MINNEAPOLIS, MN 55408-2533
(612) 227-2829
(612) 377-7501
Mailing address
3005 JAMES AVE S, MINNEAPOLIS, MN 55408-2589
(612) 227-2829
(612) 377-7501
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
LP3550
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040161700
—
MN
01
—
117T6NA OR 114T7NA
BLUE CROSS BLUE SHIELD
MN
01
—
141774
UCARE
MN
01
—
20258-11
BHP
MN
01
—
6173818
MEDICA OR UBH
MN
Enumeration date
12/02/2006
Last updated
11/10/2022
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