Individual
MARIA L BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
315 S 100 E, PROVO, UT 84606-4649
(801) 851-8554
Mailing address
PO BOX 2096, PROVO, UT 84603-2096
(801) 636-0165
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4825018-3502
UT
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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