Provider Demographics
NPI:1982738027
Name:MCANELLY, BLAIR CHRISTINE
Entity type:Individual
Prefix:MRS
First Name:BLAIR
Middle Name:CHRISTINE
Last Name:MCANELLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 EAST ST
Mailing Address - Street 2:SUITE 123
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-4976
Mailing Address - Country:US
Mailing Address - Phone:530-668-6767
Mailing Address - Fax:530-668-4010
Practice Address - Street 1:825 EAST ST
Practice Address - Street 2:SUITE 123
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-4976
Practice Address - Country:US
Practice Address - Phone:530-668-6767
Practice Address - Fax:530-668-4010
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor