| NPI | 1386883718 |
|---|---|
| Former Name | ANGEL DOMINIQUE BLAIR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024188654) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2025-01-22 |