Individual
IRA BOATNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
612 BARNES ST, JONESBORO, LA 71251-2134
(318) 533-0767
Mailing address
612 BARNES ST, JONESBORO, LA 71251-2134
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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