Individual
MISS LARA MARIE BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,BCBA
Contact information
Practice address
440 EDMOND DR, DYER, IN 46311-1523
(219) 322-1415
(219) 322-1414
Mailing address
440 EDMOND DR, DYER, IN 46311-1523
(219) 322-1415
(219) 322-1414
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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