MEDICARE: BREE BLANCHARD BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-20-145283	IN
2	103K00000X	Behavior Analyst	1-23-66510	IN

General Provider Information

NPI Number	:	1851989925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREE BLANCHARD BCBA

Provider Business Mailing Address
First Line	:	300 TICE BLVD STE 165
Second Line	:
City	:	WOODCLIFF LAKE
State	:	NJ
Zip	:	07677-8405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8902 VINCENNES CIR STE G
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-3019
Country	:	US
Telephone Number	:	317-648-9509
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	01/26/2026

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Directions to “ BREE BLANCHARD BCBA” Practice Location

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