Individual
MS. CONSTANCE BOOKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 989-9499
Mailing address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 989-9499
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100207687029
—
MA
Enumeration date
01/07/2013
Last updated
01/07/2013
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