Provider Demographics
NPI:1851511398
Name:BLANCHARD, CHANTAL I (RRT)
Entity Type:Individual
Prefix:MS
First Name:CHANTAL
Middle Name:
Last Name:BLANCHARD
Suffix:I
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19000 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2948
Mailing Address - Country:US
Mailing Address - Phone:954-430-2384
Mailing Address - Fax:
Practice Address - Street 1:19000 NW 12TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2948
Practice Address - Country:US
Practice Address - Phone:954-430-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT 2802227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered