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1235161571
MINA-AYESHA A BLAIR
WILLIAMSPORT, PA
NPI
1235161571
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: PA SW123316)
Enumeration Date
2006-07-07
Last Update Date
2014-06-23
Business Address
MINA-AYESHA A BLAIR MSW, LSW
2062 OLD LYCOMING RAOD
WILLIAMSPORT, PA 17701
Phone number: 570-505-1123
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Mailing Address
MINA-AYESHA A BLAIR MSW, LSW
65 GRATZMAR AVE
RENOVO, PA 17764-9507
Phone number: 570-858-0046
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