Provider Demographics
NPI:1083423586
Name:BLOOD, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BLOOD
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 1:21 MADISON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2641
Mailing Address - Country:US
Mailing Address - Phone:603-702-2909
Mailing Address - Fax:
Practice Address - Street 1:12 GILL ST STE 5800
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1754
Practice Address - Country:US
Practice Address - Phone:781-937-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW228829104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker