| Doctor Name: | ANGELA M BOONE-GARDNER |
| NPI Number: | 1033406962 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-C |
| License Number: | 0904007353 |
| Business Practice Address: | 10001 Derekwood Ln 210 Lanham, MD - 207064865 |
| Business Phone Number: | 4437832712 |
| Business Fax Number: | 3015525427 |
| Mailing Address: | Po Box 1822, GLEN BURNIE |
| State: | MD |
| Postal Code: | 210601822 |
| Phone Number: | 4437832712 |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2011 |
| NPI Last Update Date: | 12/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904007353 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |