Individual
ROGER BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
101 E PIER ST, PORT WASHINGTON, WI 53074-1939
(262) 284-3117
(262) 284-3087
Mailing address
285 N JANACEK RD, BROOKFIELD, WI 53045-6102
(262) 641-9050
(262) 641-9126
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1045-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39299600
—
WI
Enumeration date
07/25/2006
Last updated
01/02/2008
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