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General NPI Number Information
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NPI Number | 1568707263
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Entity Type | Individual
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Provider Name | SHANNON MELISSA BLANCHARD M.A.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 1798 BRYMAN ST
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City | HANFORD
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State | CA
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Zip | 93230-7144
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Country | US
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Telephone | 559-585-1976
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Fax |
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Provider Business Mailing Address
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Address Line | 28810 ROAD 48
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City | VISALIA
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State | CA
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Zip | 93277-9458
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 105109
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License Number State | CA
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