Provider Demographics
NPI:1164667077
Name:BLONDER, EMILY BETH
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:BETH
Last Name:BLONDER
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 1:39 BARNSTABLE ST
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1147
Mailing Address - Country:US
Mailing Address - Phone:781-254-3156
Mailing Address - Fax:
Practice Address - Street 1:39 BARNSTABLE ST
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1147
Practice Address - Country:US
Practice Address - Phone:781-254-3156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker