Provider Demographics
NPI:1689816472
Name:BLANCHARD, ANN-MARIE TEREZ (LAC)
Entity Type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:TEREZ
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 WILCOMBE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA
Mailing Address - State:CA
Mailing Address - Zip Code:93428-5246
Mailing Address - Country:US
Mailing Address - Phone:805-471-3979
Mailing Address - Fax:
Practice Address - Street 1:665 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-2268
Practice Address - Country:US
Practice Address - Phone:805-471-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12352171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist