Provider Demographics
NPI:1497051577
Name:BLOUNT, ALAN CRAIG JR (BHRS)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:CRAIG
Last Name:BLOUNT
Suffix:JR
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 W BRITTON RD
Mailing Address - Street 2:APT. # 121
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-3531
Mailing Address - Country:US
Mailing Address - Phone:918-408-2220
Mailing Address - Fax:
Practice Address - Street 1:413 W BRITTON RD
Practice Address - Street 2:APT. # 121
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-3531
Practice Address - Country:US
Practice Address - Phone:918-408-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst