| Doctor Name: | DR. JOSE C BLANCO |
| NPI Number: | 1043593023 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | |
| Business Practice Address: | B5 Calle Tabonuco Ste 203 Galeria San Patricio Guaynabo, PR - 009683004 |
| Business Phone Number: | 7879069696 |
| Business Fax Number: | |
| Mailing Address: | B5 Calle Tabonuco Ste 203, Galeria San Patricio GUAYNABO |
| State: | PR |
| Postal Code: | 009683004 |
| Phone Number: | 7879069696 |
| Fax Number: | |
| NPI Enumeration Date: | 09/26/2011 |
| NPI Last Update Date: | 02/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |