Provider Demographics
NPI:1164071890
Name:BOSKET, ZAKIYYAH DANIELLE
Entity Type:Individual
Prefix:MRS
First Name:ZAKIYYAH
Middle Name:DANIELLE
Last Name:BOSKET
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 1:401 GREENVILLE ST APT C4
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-1430
Mailing Address - Country:US
Mailing Address - Phone:864-328-5739
Mailing Address - Fax:
Practice Address - Street 1:401 GREENVILLE ST APT C4
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:SC
Practice Address - Zip Code:29670-1430
Practice Address - Country:US
Practice Address - Phone:864-328-5739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker