Provider Demographics
NPI:1659016343
Name:BLASHFORD, MARISA JORDAN (MS, NCC)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:JORDAN
Last Name:BLASHFORD
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 MOSSIDE BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3576
Mailing Address - Country:US
Mailing Address - Phone:724-755-3737
Mailing Address - Fax:
Practice Address - Street 1:2571 MOSSIDE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3576
Practice Address - Country:US
Practice Address - Phone:724-755-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor