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General NPI Number Information
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NPI Number | 1942327556
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Entity Type | Organization
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Legal Business Name | TOMMY A. BOONE, PC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 1 DUNWOODY PARK SUITE 140
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City | ATLANTA
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State | GA
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Zip | 30338-7404
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Country | US
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Telephone | 770-932-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 165 ROBERTS RD
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City | SUWANEE
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State | GA
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Zip | 30024-2334
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Country | US
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Telephone | 678-313-3549
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TOMMY AARON BOONE
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Credential | LPC
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Telephone | 678-313-3549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 02955
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License Number State | GA
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