Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-17318 | NH |
N | 103K00000X | Behavior Analyst | 57997 | NH |
NPI | 1003270554 |
---|---|
Provider Name | Lisa Blanchard |
First Address | Ashland, NH 03217-1150 |
Second Address | Ashland, NH 03217-4219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 11/04/2016 |