Individual
ANTONIO BOONE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1900 SILVER LAKE RD NW STE 210, NEW BRIGHTON, MN 55112-1786
(651) 384-2549
Mailing address
1037 VAN BUREN AVE, SAINT PAUL, MN 55104-2126
(612) 701-8234
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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