Provider Demographics
NPI:1780033936
Name:ANITA RIBEIRO-BLANCHARD P.A.
Entity type:Organization
Organization Name:ANITA RIBEIRO-BLANCHARD P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-501-8095
Mailing Address - Street 1:524 VIA GENOVA
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8626
Mailing Address - Country:US
Mailing Address - Phone:561-501-8095
Mailing Address - Fax:561-270-0811
Practice Address - Street 1:1700 S DIXIE HWY
Practice Address - Street 2:SUITE 507
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7452
Practice Address - Country:US
Practice Address - Phone:561-501-8095
Practice Address - Fax:561-270-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6591101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty