Provider Demographics
NPI:1063177277
Name:BOOKER, CHANTA MONIQUE
Entity type:Individual
Prefix:DR
First Name:CHANTA
Middle Name:MONIQUE
Last Name:BOOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ARROWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3835
Mailing Address - Country:US
Mailing Address - Phone:443-562-9657
Mailing Address - Fax:
Practice Address - Street 1:1829 REISTERSTOWN RD STE 350
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7126
Practice Address - Country:US
Practice Address - Phone:443-641-9407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No372500000XNursing Service Related ProvidersChore Provider
No374U00000XNursing Service Related ProvidersHome Health Aide