Most Relevant Information
Provider Data
NPI Number: | 1003338617 |
Provider Name: | STACY BLAZIO |
Entity Type: | Individual |
Taxonomy Code: | 101YM0800X |
Specialty: | Counselor |
License Number: |
Most Important Dates
Enumeration Date: | 07/14/2017 |
Last Updated: | 06/01/2018 |
Provider Practice Location
401 W MORRIS AVE
HAMMOND
LA
70403
Practice Location Phone/Fax
Phone: | 5670000000 |
Fax: |
Provider Mailing Location
401 W MORRIS AVE
HAMMOND
LA
704034121
Provider Mailing Phone/Fax
Phone: | 5043043737 |
Fax: |