Individual
BONNY DOMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1640 POWERS FERRY RD SE BLDG 14-200, MARIETTA, GA 30067-1459
(888) 551-5168
Mailing address
1640 POWERS FERRY RD SE STE 200, MARIETTA, GA 30067-5491
(888) 551-5168
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC015728
GA
Other
Enumeration date
06/03/2025
Last updated
07/09/2025
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