Individual
ASANTI BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5461 HILLANDALE DR, LITHONIA, GA 30058-4841
(470) 361-2976
Mailing address
5461 HILLANDALE DR STE 100, LITHONIA, GA 30058-4842
(612) 402-9763
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-159267
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
N/A
—
Enumeration date
01/05/2021
Last updated
05/10/2023
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