Provider Demographics
NPI:1306246947
Name:BOOKER, VERONICA (MSW)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:BOOKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 169TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46323-1508
Mailing Address - Country:US
Mailing Address - Phone:219-554-0688
Mailing Address - Fax:
Practice Address - Street 1:2714 169TH ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323-1508
Practice Address - Country:US
Practice Address - Phone:219-554-0688
Practice Address - Fax:219-554-1773
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33000755A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical