Individual
ANGELA M BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
308 GATEHOUSE LN UNIT D, ODENTON, MD 21113-2689
(443) 214-8221
Mailing address
PO BOX 56, ODENTON, MD 21113-0056
(443) 214-8221
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
0904007353
VA
1041C0700X
Clinical Social Worker
Primary
16065
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420583900
—
MD
Enumeration date
06/29/2011
Last updated
04/09/2021
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