Individual
DR. BOONE LEONARD BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., LPC
Contact information
Practice address
376 TALLY MOUNTAIN RD N, JASPER, GA 30143-4706
(770) 846-8161
Mailing address
376 TALLY MOUNTAIN RD N, JASPER, GA 30143-4706
(770) 846-8161
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001999
GA
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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