Individual
MR. KENNETH CARTER BOATNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D.,MPH
Contact information
Practice address
565 PEACHTREE STREET, N.E., SUITE 1407, ATLANTA, GA 30308-2277
(617) 784-3535
Mailing address
565 PEACHTREE ST NE UNIT 1407, ATLANTA, GA 30308-2277
(617) 784-3535
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
003786
GA
103T00000X
Psychologist
4286
MA
Other
Enumeration date
07/30/2015
Last updated
08/12/2015
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