Provider Demographics
NPI:1114535994
Name:BLUNT, MEGHAN THERESE (MS)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:THERESE
Last Name:BLUNT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 THE CITY DR S # ZC4482
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3201
Mailing Address - Country:US
Mailing Address - Phone:714-456-5837
Mailing Address - Fax:714-456-5330
Practice Address - Street 1:333 CITY BLVD W STE 800
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-5901
Practice Address - Country:US
Practice Address - Phone:714-456-5837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS