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General NPI Number Information
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NPI Number | 1679438584
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Entity Type | Individual
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Provider Name | MARLENE BLANCO CMI# 104734
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Gender | Female
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 4117 N ELIZABETH ST
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City | PUEBLO
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State | CO
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Zip | 81008-2009
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Country | US
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Telephone | 719-545-0788
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Fax |
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Provider Business Mailing Address
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Address Line | 3229 WESTVIEW DR
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City | PUEBLO
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State | CO
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Zip | 81003-3858
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Country | US
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Telephone | 917-375-9119
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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 | 171R00000X
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Taxonomy Name | Interpreter
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License Number | 104734
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License Number State |
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