Search › Georgia › 103TC0700X
Dia Boutwell, PHD
NPI 1740757731 · on the registry since 2018 · sole proprietor
Practice
- Address
- 125 Howard Ln Ste B
Fayetteville, GA 30215 - Phone
- (502) 867-4851
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 103TC0700X
103TC0700X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-02-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia