Male or Other

Kelly L. Blair PH.D

Clinical Psychologist in Jackson, TN(View on Map)

Full Name

Kelly Lane Blair PH.D

NPI Number

1891711131

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/13/2006

Specialties

(Taxonomies)

Code

103TC0700X
103TR0400X

Primary Taxonomy

Yes
No

Licenses

State

Tennessee

License Number

1706

Contact
Information

Purpose

Mailing
Location

Address

1804 HIGHWAY 45 BYP
708 W FOREST AVE

City

Jackson
Jackson

State

TN
TN

Postal Code

38305-4436
38301-3901

Country

US
US

Telephone Number

(731) 660-8759
(731) 425-4930

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/31/2009

Provider Address

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