Individual
MRS. EDNA FAYE BOOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LISAC
Contact information
Practice address
222 E MAIN ST STE 117, BARSTOW, CA 92311-2361
(760) 255-1497
(760) 256-2920
Mailing address
4885 BUCK SPRINGS RD, PINETOP, AZ 85935-8139
(928) 266-8600
(760) 314-7442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15179
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
5034
LA
101YM0800X
Mental Health Counselor
4179
LA
101YP2500X
Professional Counselor
Primary
17302
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801193834
—
CA
Enumeration date
02/28/2011
Last updated
06/04/2024
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