Provider Demographics
NPI:1255788121
Name:BLANCHARD, YOLANDE
Entity type:Individual
Prefix:
First Name:YOLANDE
Middle Name:
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE YOLANDE
Other - Middle Name:
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1806 NW 142ND LN
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-2173
Mailing Address - Country:US
Mailing Address - Phone:305-496-9421
Mailing Address - Fax:
Practice Address - Street 1:1806 NW 142ND LN
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-2173
Practice Address - Country:US
Practice Address - Phone:305-496-9421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst