Blair, Elizabeth Dale
Blair, Elizabeth Dale is an individual health care provider with primary practice located at 280 North Providence Road , Media PA 19063. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Blair, Elizabeth Dale can be contacted via phone (610) 565-1129.Contact Information
Primary practice address
280 North Providence Road
Media PA 19063
Phone: (610) 565-1129
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PS0033762 | Pennsylvania |
Profile Details
| NPI number | 1033272216 |
|---|---|
| LBN Legal business name | Blair, Elizabeth Dale |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Sep 8th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033272216 | NPPES |
| Pennsylvania | MEDICAID | 280714000 |
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