Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 8629 | NC |
NPI | 1013317023 |
---|---|
Provider Name | Ms. Bethany Grace Blanchard |
First Address | Chapel Hill, NC 27514-4220 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2014 |
Last Update Date | 27/08/2014 |