Individual
WANDA SIENA BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCMH
Contact information
Practice address
651 N BROAD ST STE 205 #4462, MIDDLETOWN, DE 19709-6402
(302) 985-9831
Mailing address
651 N BROAD ST STE 205 #4462, MIDDLETOWN, DE 19709-6402
(302) 985-9831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC0000797
DE
101YP2500X
Professional Counselor
LC8003
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13591550
CAQH ID
—
Enumeration date
03/11/2009
Last updated
02/09/2021
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