Individual
BIANCA RAE BLAIKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, LCMHC
Contact information
Practice address
172 FAIRFIELD ST, SAINT ALBANS, VT 05478-1743
(802) 488-6900
(802) 488-6919
Mailing address
PO BOX 617, ESSEX JUNCTION, VT 05453-0617
(802) 734-3312
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151.0129115
VT
101YM0800X
Mental Health Counselor
Primary
068.0124899
VT
Other
Enumeration date
06/08/2018
Last updated
04/09/2022
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