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Individual

MR. JACK R BOYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.ED. L.M.F.T.

Contact information

Practice address
2801 BUFORD HWY NE, T-70, ATLANTA, GA 30329-2149
(404) 315-7474
(404) 982-0006
Mailing address
2801 BUFORD HWY NE, T-70, ATLANTA, GA 30329-2149
(404) 315-7474
(404) 982-0006

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0599
GA

Other

Enumeration date
04/17/2007
Last updated
07/08/2007
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