MEDICARE: JANET LYNNE BONER M.ED.,MT-BC, NICU MT

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	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1932401973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET LYNNE BONER M.ED.,MT-BC, NICU MT

Provider Business Mailing Address
First Line	:	2998 CHRISTOPHERS CT
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-1631
Country	:	US
Telephone Number	:	770-579-2554
Fax Number	:	770-579-2554

Provider Business Practice Location Address
First Line	:	4880 LOWER ROSWELL RD
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-4375
Country	:	US
Telephone Number	:	770-977-9457
Fax Number	:

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

Provider Enumeration Date	:	11/24/2010
Last Update Date	:	05/02/2015

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