Provider Demographics
NPI:1407574551
Name:BLOISE, K'SHA LEANDRA
Entity Type:Individual
Prefix:
First Name:K'SHA
Middle Name:LEANDRA
Last Name:BLOISE
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 1:5A COW POND LN
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-4180
Mailing Address - Country:US
Mailing Address - Phone:508-360-4517
Mailing Address - Fax:
Practice Address - Street 1:99 BISHOP RICHARD ALLEN DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3428
Practice Address - Country:US
Practice Address - Phone:800-841-8371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor