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General NPI Number Information
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NPI Number | 1942517958
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Entity Type | Organization
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Legal Business Name | SANDRA L BLANTON LMHC
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 09/13/2010
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Provider Practice Location Address
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Address Line | 14080 SE 27TH CT
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City | SUMMERFIELD
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State | FL
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Zip | 34491-2806
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Country | US
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Telephone | 561-762-9952
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Fax |
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Provider Business Mailing Address
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Address Line | 14080 SE 27TH CT
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City | SUMMERFIELD
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State | FL
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Zip | 34491-2806
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Country | US
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Telephone | 561-762-9952
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | SANDRA L BLANTON
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Credential | LMHC
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Telephone | 561-762-9952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH8524
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License Number State | FL
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