Suzett D. Blount | |
3595 Hiram Douglasville Hwy Ste 108 Hiram GA 30141-4963 | |
(770) 635-7847 | |
Not Available |
Full Name | Suzett D. Blount |
---|---|
Speciality | Counselor - Professional |
Location | 3595 Hiram Douglasville Hwy Ste 108, Hiram, Georgia |
Authorized Official Name and Position | Suzette Delicia Williams (PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 6782506026 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Suzett D. Blount 147 Forrest Park Ln Dallas GA 30157-9667 Ph: (470) 985-6858 | Suzett D. Blount 3595 Hiram Douglasville Hwy Ste 108 Hiram GA 30141-4963 Ph: (770) 635-7847 |
NPI Number | 1588253280 |
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Provider Enumeration Date | 01/16/2021 |
Last Update Date | 08/26/2024 |
Certification Date | 08/26/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588253280 | NPI | - | NPPES |
1942823901 | Medicaid | GA | |
011523 | Other | GA | LPC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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