Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | PY8257 | FL |
Y | 103TC0700X | Clinical Psychologist | PY8257 | FL |
NPI | 1154584050 |
---|---|
Provider Name | Dr. Blair Hershman Mor |
First Address | Boca Raton, FL 33486-1344 |
Second Address | Boca Raton, FL 33486-1344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 01/07/2020 |