Provider Demographics
NPI:1023854320
Name:MUNOH, BLANDINE
Entity type:Individual
Prefix:
First Name:BLANDINE
Middle Name:
Last Name:MUNOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13807 BRIARWOOD DR APT 1622
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1350
Mailing Address - Country:US
Mailing Address - Phone:240-524-1975
Mailing Address - Fax:
Practice Address - Street 1:13807 BRIARWOOD DR APT 1622
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1350
Practice Address - Country:US
Practice Address - Phone:240-524-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
DC172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator