Individual
LATAUSHA JEANELL BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
2025 E MAIN ST, SUITE 208, RICHMOND, VA 23223-7069
(804) 439-7578
(804) 302-7976
Mailing address
PO BOX 38936, HENRICO, VA 23231-1311
(804) 439-7578
(804) 302-7976
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006267
VA
Other
Enumeration date
09/12/2013
Last updated
08/10/2015
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