Provider Demographics
NPI:1013112309
Name:BLANCHARD, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 STUART NELSON PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-9678
Mailing Address - Country:US
Mailing Address - Phone:270-442-9502
Mailing Address - Fax:270-442-1954
Practice Address - Street 1:142 STUART NELSON PARK ROAD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9678
Practice Address - Country:US
Practice Address - Phone:270-442-9502
Practice Address - Fax:270-442-1954
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY141633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist