Provider Demographics
NPI:1003215815
Name:BLACHE, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BLACHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 BAPTIST RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1117
Mailing Address - Country:US
Mailing Address - Phone:412-882-9929
Mailing Address - Fax:
Practice Address - Street 1:4701 BAPTIST RD
Practice Address - Street 2:SUITE 208
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-1117
Practice Address - Country:US
Practice Address - Phone:412-882-9929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006114101YM0800X
1-13-14975103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst