DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. THERESA ANN BOOMER, MS

Active Sole Proprietor

Genetic Counselor · CLANCY, MT

Registration Details

NPI Number
1205111499
Provider Type
Individual
Gender
Female
NPI Issued
Oct 19, 2011 (14.549258398221 yrs)
Last Updated
Oct 19, 2011
Licenses
246.000083 (IL)
GC0000000027 (TN)
Sole Proprietor
Yes

Practice Information

Address
4 PINE RIDGE CIR
CLANCY, MT, 596349760
Browse MT providers · Browse ZIP 59634
Phone
4064220411
Primary Specialty
Genetic Counselor
170300000X
Additional Specialty
Genetic Counselor
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.