Individual
LASONNIA D BLUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 274-7628
Mailing address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 274-7628
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
007163
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606284H
—
GA
05
—
300030912A
—
GA
Enumeration date
04/21/2014
Last updated
04/24/2014
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