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Individual

DR. JEREMY LUCAS BLUNT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MTH, PSY.D

Contact information

Practice address
11616 SOUTHFORK AVE STE 400, BATON ROUGE, LA 70816-5241
(225) 955-4971
Mailing address
11616 SOUTHFORK AVE STE 400, BATON ROUGE, LA 70816-5241
(225) 955-4971

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
JB722337
LA

Other

Enumeration date
08/24/2017
Last updated
11/28/2021
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