Individual
CASEY BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
411 S 19TH ST # 1A, PHILADELPHIA, PA 19146-1443
(682) 225-1375
Mailing address
411 S 19TH ST # 1A, PHILADELPHIA, PA 19146-1443
(682) 225-1375
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
221700000X
Art Therapist
Primary
—
—
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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