Provider Demographics
NPI:1831423615
Name:HARLOW, BLENDA ANN (BS)
Entity type:Individual
Prefix:MS
First Name:BLENDA
Middle Name:ANN
Last Name:HARLOW
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 FAIRHAVEN AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-2932
Mailing Address - Country:US
Mailing Address - Phone:505-717-1214
Mailing Address - Fax:505-877-7063
Practice Address - Street 1:1101 LOPEZ RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-3954
Practice Address - Country:US
Practice Address - Phone:717-362-1418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor