Ilene Blaisch

NPI 1104155290 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1104155290
Enumeration Date 12/18/2009
Last Updated 12/18/2009
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name ILENE ILENE
Position PSYCHOTHERAPIST
Phone (949) 910-5654
Fax
Practice Location
161 AVENIDA CABRILLO
SAN CLEMENTE CA, 92672-4040, US
Phone (949) 910-5654
Fax
Business Location
161 AVENIDA CABRILLO
SAN CLEMENTE CA, 92672-4040, US
Phone (949) 910-5654
Fax
Toxanomy
Taxonomy Code 251S00000X
License State
License Number
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According to our database, Ilene Blaisch NPI is 1104155290, taxonomy code is 251S00000X Ilene Blaisch physically located at 161 Avenida Cabrillo, San Clemente CA, 92672-4040. NPI Number 1033115704 has the healthcare provider type.

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1104155290 NPI number is provided on an as is basis without warranty of any kind. 1104155290 is maintained by the National Plan & Provider Enumeration System. The contents of Ilene Blaisch are for informational purposes only.