Individual
MRS. AUDREY ANDERSON BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
913 STATE ST, NEW HAVEN, CT 06511-3926
(203) 503-3668
(203) 503-3562
Mailing address
913 STATE ST, NEW HAVEN, CT 06511-3926
(203) 503-3668
(203) 503-3562
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007351
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
07/25/2010
Last updated
07/30/2012
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