Provider Demographics
NPI:1497120398
Name:BLOUNT, WILLIAM (HOME CARE WORKER)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:BLOUNT
Suffix:
Gender:M
Credentials:HOME CARE WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 MISSISSIPPI AVE SE APT 103
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2408
Mailing Address - Country:US
Mailing Address - Phone:704-726-8871
Mailing Address - Fax:
Practice Address - Street 1:237 MISSISSIPPI AVE SE APT 103
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2408
Practice Address - Country:US
Practice Address - Phone:704-726-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No104100000XBehavioral Health & Social Service ProvidersSocial Worker