Provider Demographics
NPI:1316786163
Name:BOOHER-TERRY, DAWN MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:BOOHER-TERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 TINTED COPPER
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-1999
Mailing Address - Country:US
Mailing Address - Phone:316-300-3333
Mailing Address - Fax:
Practice Address - Street 1:32600 US HIGHWAY 281 N STE 1101
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-3319
Practice Address - Country:US
Practice Address - Phone:830-624-6846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX632201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical