| Bluntly Coached, Llc | |
|
30435 Mount Vernon Rd Princess Anne MD 21853-1437 | |
| (443) 754-2164 | |
| Not Available |
| Full Name | Bluntly Coached, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 30435 Mount Vernon Rd, Princess Anne, Maryland |
| Authorized Official Name and Position | Ganiyat Badmus (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4437542164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluntly Coached, Llc 30435 Mount Vernon Rd Princess Anne MD 21853-1437 Ph: (443) 754-2164 | Bluntly Coached, Llc 30435 Mount Vernon Rd Princess Anne MD 21853-1437 Ph: (443) 754-2164 |
| NPI Number | 1023658606 |
|---|---|
| Provider Enumeration Date | 01/10/2020 |
| Last Update Date | 01/10/2020 |
| Certification Date | 01/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023658606 | NPI | - | NPPES |
| 302168800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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