Healthcare Provider Details

I. General information

NPI: 1649440934
Provider Name (Legal Business Name): MRS. ANDREA DAWN BLANCHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 OLD CANAL DR
LOWELL MA
01851-2730
US

IV. Provider business mailing address

22 STEARNS RD
AMHERST NH
03031-2705
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-1736
  • Fax:
Mailing address:
  • Phone: 719-322-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: