Individual
KENYETTA BOOKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13650 MARSH VIEW BLVD APT 102, ROGERS, MN 55374-6034
(318) 302-9192
Mailing address
13650 MARSH VIEW BLVD APT 102, ROGERS, MN 55374-6034
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
529084
MN
235Z00000X
Speech-Language Pathologist
Primary
7127
LA
Other
Enumeration date
07/06/2024
Last updated
01/19/2026
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