| 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 | Suzett Delicia Blount (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 3595 Hiram Douglasville Hwy Ste 108 Hiram GA 30141-4963 Ph: (770) 635-7847 | Suzett D. Blount 3595 Hiram Douglasville Hwy Ste 108 Hiram GA 30141-4963 Ph: (770) 635-7847 |
| NPI Number | 1588253280 |
|---|---|
| Provider Enumeration Date | 01/16/2021 |
| Last Update Date | 12/08/2021 |
| Certification Date | 12/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588253280 | NPI | - | NPPES |
| 011523 | Other | GA | LPC |
| 1942823901 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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