Healthcare Provider Details

I. General information

NPI: 1932401973
Provider Name (Legal Business Name): JANET LYNNE BONER M.ED.,MT-BC, NICU MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2010
Last Update Date: 05/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 LOWER ROSWELL RD
MARIETTA GA
30068-4375
US

IV. Provider business mailing address

2998 CHRISTOPHERS CT
MARIETTA GA
30062-1631
US

V. Phone/Fax

Practice location:
  • Phone: 770-977-9457
  • Fax:
Mailing address:
  • Phone: 770-579-2554
  • Fax: 770-579-2554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: