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Individual

MS. ASHLEY M BLANC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
606 WASHINGTON ST, RAVENSWOOD, WV 26164
(304) 273-1033
(304) 273-1034
Mailing address
PO BOX 609, ELIZABETH, WV 26143-0609
(304) 275-3301
(304) 275-4798

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1241
WV
103TC0700X
Clinical Psychologist
Primary
1241
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1356793095
WV
Enumeration date
07/06/2016
Last updated
12/21/2023
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