Dr. Jonathan Matthew Blair, Ph.D.
Psychologist, Clinical in Lansing, MI. Individual provider (NPI-1).
NPI number1285940064
StatusActive
Last updated in NPPESDec 28, 2011
Details
- NPI
- 1285940064
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jonathan Matthew Blair
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 31, 2010
- Last updated
- Dec 28, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 6301014658 | MI | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
5123 W St Joe HwySuite 103
Lansing, MI 48917-4093
Phone 517-323-4099 · Fax 517-323-3334
Mailing address
5123 W St Joe HwySuite 103
Lansing, MI 48917-4093
Phone 517-323-4099 · Fax 517-323-3334
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