Blanchard, Roger
Blanchard, Roger is an individual health care provider with primary practice located at 101 E Pier St , Port Washington WI 53074-1939. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Blanchard, Roger can be contacted via phone (262) 284-3117.Contact Information
Primary practice address
101 E Pier St
Port Washington WI 53074-1939
Phone: (262) 284-3117
Fax: (262) 284-3087
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1045-123 | Wisconsin |
Profile Details
| NPI number | 1073536793 |
|---|---|
| LBN Legal business name | Blanchard, Roger |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jan 2nd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073536793 | NPPES |
| Wisconsin | MEDICAID | 39299600 |
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