Male or Other

Mr. Kenneth C. Boatner ED.D.,MPH

Psychologist in Atlanta, GA(View on Map)

Full Name

Mr. Kenneth Carter Boatner ED.D.,MPH

NPI Number

1306221411

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/30/2015

Specialties

(Taxonomies)

Code

103T00000X

Primary Taxonomy

Yes

Licenses

State

Georgia
Massachusetts

License Number

003786
4286

Contact
Information

Purpose

Mailing
Location

Address

565 PEACHTREE ST NE UNIT 1407
565 PEACHTREE STREET, N.E.

City

Atlanta
Atlanta

State

GA
GA

Postal Code

30308-2277
30308-2277

Country

US
US

Telephone Number

(617) 784-3535
(617) 784-3535

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/12/2015

Provider Address

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