Individual
JENNA MAE BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1100 INDUS ST, FAIRMONT, MN 56031-9548
(701) 899-2803
Mailing address
1100 INDUS ST, FAIRMONT, MN 56031-9548
(701) 899-2803
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305783
MN
Other
Enumeration date
11/01/2023
Last updated
09/30/2024
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