Provider Demographics
NPI:1326896325
Name:BOATNER, RAIN ASPEN
Entity type:Individual
Prefix:
First Name:RAIN
Middle Name:ASPEN
Last Name:BOATNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 WOODDELL BLVD
Mailing Address - Street 2:STE 750
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806
Mailing Address - Country:US
Mailing Address - Phone:225-930-8058
Mailing Address - Fax:
Practice Address - Street 1:2156 WOODDELL BLVD
Practice Address - Street 2:STE 750
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-930-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health