Doctor Name: | MRS. REBECCA ANN BLODGETT |
NPI Number: | 1205153780 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LMHC |
License Number: | |
Business Practice Address: | 205 School St Gardner, MA - 014402781 |
Business Phone Number: | 9786322321 |
Business Fax Number: | 9786303049 |
Mailing Address: | 205 School St, GARDNER |
State: | MA |
Postal Code: | 014402781 |
Phone Number: | 9786322321 |
Fax Number: | 9786303049 |
NPI Enumeration Date: | 04/23/2010 |
NPI Last Update Date: | 04/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |