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General NPI Number Information
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NPI Number | 1386254431
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Entity Type | Individual
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Provider Name | TONI BOONE
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 1314 RIVERLAND RD SE
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City | ROANOKE
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State | VA
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Zip | 24014-3610
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Country | US
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Telephone | 540-566-3670
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Fax | 434-237-1737
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Provider Business Mailing Address
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Address Line | 693 LEESVILLE RD
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City | LYNCHBURG
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State | VA
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Zip | 24502-2828
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Country | US
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Telephone | 434-200-5750
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Fax | 434-237-1737
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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