Individual
DIANE BOULAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
55 JEFFERSON PKWY # 55B, NEWNAN, GA 30263-5813
(770) 683-6946
(770) 683-6949
Mailing address
55 JEFFERSON PKWY # 55B, NEWNAN, GA 30263-5813
(678) 477-3476
(770) 683-6946
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
164W00000X
Licensed Practical Nurse
Primary
LPN061853
GA
Other
Enumeration date
05/18/2011
Last updated
03/18/2026
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