Individual provider · Type 1 NPI

Bonny Domoto, LPC

Mental Health Counselor · Marietta, GA

NPI number 1740173046 Active

Practice location

1640 Powers Ferry Rd SE Bldg 14-200
Marietta, GA 30067-1459

Call (888) 551-5168 Map

Mailing address

1640 Powers Ferry Rd SE Ste 200
Marietta, GA 30067-5491

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLPC015728 (GA)

Mental Health Counselor: Definition to come...

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About NPI 1740173046

Bonny Domoto, LPC's National Provider Identifier is 1740173046, issued on Jun 3, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Marietta, GA. The record was last updated on Jul 9, 2025.