Individual
CODY BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 W SPRINGFIELD AVE, CHAMPAIGN, IL 61820-4716
(217) 398-8464
Mailing address
PO BOX 492, SIDNEY, IL 61877-0492
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
B452-1019-0249
IL
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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