Organization
BLUNTLY COACHED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GANIYAT BADMUS (CHIEF EXECUTIVE OFFICER)
(443) 754-2164
Entity
Organization
Contact information
Practice address
11779 SOMERSET AVE STE 12, PRINCESS ANNE, MD 21853-1271
(443) 754-2164
(866) 993-1076
Mailing address
11779 SOMERSET AVE STE 12, PRINCESS ANNE, MD 21853-1271
(443) 754-2164
(866) 993-1076
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302168800
—
MD
Enumeration date
03/07/2019
Last updated
01/09/2020
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