Individual
DR. CHARLES WILLIAM BLANCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3205 ARROWHEAD RD, LAS CRUCES, NM 88011-4786
(575) 521-1725
(575) 521-1725
Mailing address
3205 ARROWHEAD RD, LAS CRUCES, NM 88011-4786
(575) 521-1725
(575) 521-1725
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
622
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000F4193
—
NM
Enumeration date
04/11/2007
Last updated
01/14/2011
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