Provider Information for 1629177464
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Ms. BETTE A BLONDIN LCSW
Sex: Female
NPI: 1629177464
Last Updated: 2012-05-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1629177464 | ||||||||
| Enumeration Date | 2006-09-21 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 200 JAMES DR EMERALD ISLE, NC 28594-3019 United States Phone: 928-848-1867 | Fax:866-807-4712 | ||||||||
| Primary Practice Address | 142 FAIRVIEW DR EMERALD ISLE, NC 28594-2711 United States Phone: 252-269-5785 | Fax:866-807-4712 | ||||||||
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