Provider Demographics
NPI:1518207935
Name:BOOZER, SHENIKA T (MS)
Entity Type:Individual
Prefix:
First Name:SHENIKA
Middle Name:T
Last Name:BOOZER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2512
Mailing Address - Country:US
Mailing Address - Phone:412-589-6724
Mailing Address - Fax:
Practice Address - Street 1:4 CARRIAGE LN STE 405
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6024
Practice Address - Country:US
Practice Address - Phone:843-709-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2024-01-25
Deactivation Date:2024-01-09
Deactivation Code:
Reactivation Date:2024-01-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional