Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 9872 | MA |
Y | 103TC0700X | Clinical Psychologist | 9872 | MA |
NPI | 1013103589 |
---|---|
Provider Name | Mrs. Melanie C Blount |
First Address | Lynn, MA 01901-1201 |
Second Address | Lynn, MA 01901-1201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2007 |
Last Update Date | 25/04/2014 |