Individual
THERESA FLANNERY-BLACHURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
11 MILL ST, HOULTON, ME 04730-1877
(207) 532-6523
(207) 532-3873
Mailing address
11 MILL ST, HOULTON, ME 04730-1877
(207) 532-6523
(207) 532-3873
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11557
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
432024199
MAINE CARE NUMBER
ME
Enumeration date
03/26/2007
Last updated
05/29/2008
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