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Individual

KERETH LYNN BLANCHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2 DUDLEY ST, SUITE 200, PROVIDENCE, RI 02905-3236
(401) 457-1580
(401) 831-0500
Mailing address
2 DUDLEY ST, SUITE 200, PROVIDENCE, RI 02905-3236
(401) 457-1580
(401) 831-0500

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00942
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT00942
STATE LICENSE NUMBER
RI
Enumeration date
06/30/2009
Last updated
10/17/2011
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