Provider Demographics
NPI:1154575280
Name:BLAIR, JAYSON THOMAS (CERTIFIED LIFE COACH)
Entity type:Individual
Prefix:MR
First Name:JAYSON
Middle Name:THOMAS
Last Name:BLAIR
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Gender:M
Credentials:CERTIFIED LIFE COACH
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Mailing Address - Street 1:44100 ASHBURN SHOPPING PLZ
Mailing Address - Street 2:SUITE 251
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147
Mailing Address - Country:US
Mailing Address - Phone:703-723-2999
Mailing Address - Fax:703-723-4144
Practice Address - Street 1:44110 ASHBURN SHOPPING PLZ
Practice Address - Street 2:SUITE 251
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3999
Practice Address - Country:US
Practice Address - Phone:703-723-2999
Practice Address - Fax:703-723-4144
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst