Provider Demographics
NPI:1467801514
Name:BLASSER, HALEY
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:BLASSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MANOMET POINT RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-1126
Mailing Address - Country:US
Mailing Address - Phone:508-830-4380
Mailing Address - Fax:
Practice Address - Street 1:70 MANOMET POINT RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-1126
Practice Address - Country:US
Practice Address - Phone:508-830-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2024-12-10
Deactivation Date:2019-12-13
Deactivation Code:
Reactivation Date:2020-10-14
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool