Individual
CHANELL D BOOKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MACKENAN DR, CARY, NC 27511-7903
(919) 371-2848
Mailing address
1015 GLENDALE DR APT 1A, GREENSBORO, NC 27406-6455
(724) 786-8812
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1077126
NC
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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