Provider Demographics
NPI:1043357940
Name:BLANCHEY, RAYMOND M (LADC)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:M
Last Name:BLANCHEY
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 695
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-0695
Mailing Address - Country:US
Mailing Address - Phone:405-390-8131
Mailing Address - Fax:405-390-8134
Practice Address - Street 1:600 NW 23RD ST
Practice Address - Street 2:SUITE 204
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1469
Practice Address - Country:US
Practice Address - Phone:405-503-9997
Practice Address - Fax:405-601-0324
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK331101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)