Individual
MAYRA H BLANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30630 HWY. 72 WEST, MADISON, AL 35756
(888) 891-9339
Mailing address
3903 COOPER STREET, HUNTSVILLE, AL 35801
(256) 536-4582
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0292
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0292
OT LICENSE
AL
Enumeration date
12/29/2006
Last updated
07/08/2007
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