MEDICARE: ANDREW BLASDELL

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

General Provider Information

NPI Number	:	1962351551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW BLASDELL

Provider Business Mailing Address
First Line	:	4039 E MONTE VISTA DR APT 1
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5535
Country	:	US
Telephone Number	:	623-432-4369
Fax Number	:

Provider Business Practice Location Address
First Line	:	2090 N KOLB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85715-4149
Country	:	US
Telephone Number	:	520-505-2810
Fax Number	:

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

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

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Directions to “ ANDREW BLASDELL ” Practice Location

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