Individual
LESLIE A BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3101 WEST 2ND CT, RUSSELLVILLE, AR 72801
(479) 567-5654
(479) 567-5661
Mailing address
P.O. BOX 10323, RUSSELLVILLE, AR 72812
(479) 567-5654
(479) 567-5661
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
09-16P
AR
103TC0700X
Clinical Psychologist
07-7E
AR
Other
Enumeration date
09/05/2008
Last updated
01/08/2018
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