Provider Demographics
NPI:1609208974
Name:BLEWSTER, MARIA FARHA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:FARHA
Last Name:BLEWSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:FARHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3010 E FRUITVALE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-5261
Mailing Address - Country:US
Mailing Address - Phone:480-706-1406
Mailing Address - Fax:
Practice Address - Street 1:3010 E FRUITVALE AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-5261
Practice Address - Country:US
Practice Address - Phone:480-706-1406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSW-1524-I1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical