Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2006005129 | MO |
NPI | 1003137183 |
---|---|
Provider Name | Dr. Daniel Lee Blash SR. |
First Address | Florissant, MO 63031-1163 |
Second Address | Florissant, MO 63031-1163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2010 |
Last Update Date | 12/06/2010 |