Provider Demographics
NPI:1417787623
Name:BOOKER, TAMIA LANEE
Entity type:Individual
Prefix:
First Name:TAMIA
Middle Name:LANEE
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 1:1213 E 170TH STREET
Mailing Address - Street 2:DOWN
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110
Mailing Address - Country:US
Mailing Address - Phone:216-482-4537
Mailing Address - Fax:
Practice Address - Street 1:1213 E 170TH STREET
Practice Address - Street 2:DOWN
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110
Practice Address - Country:US
Practice Address - Phone:216-482-4537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator