Provider Demographics
NPI:1891723276
Name:BLANCHARD, MICHELLE MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 WASHINGTON ST
Mailing Address - Street 2:PO BOX 650038
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2001
Mailing Address - Country:US
Mailing Address - Phone:617-332-7244
Mailing Address - Fax:
Practice Address - Street 1:1298 WASHINGTON ST
Practice Address - Street 2:WEST NEWTON HEARING CENTER
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2001
Practice Address - Country:US
Practice Address - Phone:617-332-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA603231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
470199OtherTUFTS
MAAD0006OtherBLUE CROSS BLUE SHIELD
605850OtherHCHP
MAAD0006OtherBLUE CROSS BLUE SHIELD