Provider Demographics
NPI:1518154582
Name:BOOKER-TINDALL, CHONITA (LGSW)
Entity Type:Individual
Prefix:MRS
First Name:CHONITA
Middle Name:
Last Name:BOOKER-TINDALL
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 TOWANDA AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7827
Mailing Address - Country:US
Mailing Address - Phone:410-383-4942
Mailing Address - Fax:410-383-4513
Practice Address - Street 1:3101 TOWANDA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7827
Practice Address - Country:US
Practice Address - Phone:410-383-4942
Practice Address - Fax:410-383-4513
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG05926104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker