Healthcare Provider Details

I. General information

NPI: 1174194245
Provider Name (Legal Business Name): ANNA JO BLANCHARD MS, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CAHABA PARK CIR STE 116
BIRMINGHAM AL
35242-5041
US

IV. Provider business mailing address

200 CAHABA PARK CIR STE 116
BIRMINGHAM AL
35242-5041
US

V. Phone/Fax

Practice location:
  • Phone: 205-253-6903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2024-007
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: