Individual
DESIREE BLUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 BROADWAY, BAYONNE, NJ 07002-3627
(609) 486-2150
Mailing address
1301 WALL ST W APT 6304, LYNDHURST, NJ 07071-3542
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01061000
NJ
225X00000X
Occupational Therapist
OT008421
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BHP841495851
BLUECROSS BLUESHIELD
GA
Enumeration date
07/25/2022
Last updated
07/25/2022
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