Basic Information
| Provider Information | |||||||||
| NPI: | 1043662646 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BLANCHARD | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1612 GENERAL HOWE DR | ||||||||
| Address2: | |||||||||
| City: | PHOENIXVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194604712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4844776326 | ||||||||
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| Practice Location | |||||||||
| Address1: | 723 WHEATLAND ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIXVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194605361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104159301 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2016 | ||||||||
| LastUpdateDate: | 07/07/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | SW133401 | PA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.