MEDICARE: DARIELL R BOONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1124794334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIELL R BOONE

Provider Business Mailing Address
First Line	:	5227 W ADAMS AVE APT 1027
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-4859
Country	:	US
Telephone Number	:	216-971-3304
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 E MOCKINGBIRD LN
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-1239
Country	:	US
Telephone Number	:	254-216-3120
Fax Number	:	888-885-3307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2021
Last Update Date	:	01/15/2026

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Directions to “ DARIELL R BOONE ” Practice Location

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