Provider Demographics
NPI:1831787811
Name:BLANTON MORR, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:BLANTON MORR
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 1:2230 VILLAGE MALL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4023
Mailing Address - Country:US
Mailing Address - Phone:419-775-7662
Mailing Address - Fax:
Practice Address - Street 1:2230 VILLAGE MALL DR STE 200
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-4023
Practice Address - Country:US
Practice Address - Phone:419-543-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 251X00000X, 385HR2060X, 376J00000X, 3747P1801X
OH347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No253Z00000XAgenciesIn Home Supportive Care
No251X00000XAgenciesSupports Brokerage
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant