JASPER M BOOMER

CHANTILLY, VA
NPI1679227623
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: VA  0718000456)
Enumeration Date2022-02-08
Last Update Date2022-02-08
Business Address
JASPER M BOOMER LSATP
4229 LAFAYETTE CTR DR STE 1675
CHANTILLY, VA 20151-1270
Phone number: 855-326-4673
Mailing Address
JASPER M BOOMER LSATP
4229 LAFAYETTE CTR DR STE 1675
CHANTILLY, VA 20151-1270
Phone number: 855-326-4673
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