Provider Demographics
NPI:1215718085
Name:BLUNT, EMILEA
Entity type:Individual
Prefix:
First Name:EMILEA
Middle Name:
Last Name:BLUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMLEA
Other - Middle Name:
Other - Last Name:BLUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDCA
Mailing Address - Street 1:80 DICKMAN DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1508
Mailing Address - Country:US
Mailing Address - Phone:937-829-2772
Mailing Address - Fax:
Practice Address - Street 1:80 DICKMAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-1508
Practice Address - Country:US
Practice Address - Phone:937-829-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor