Provider Demographics
NPI:1578995858
Name:BOOZER, AMBER (BCBA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BOOZER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 ALUM SPRING DR STE 202
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8011
Mailing Address - Country:US
Mailing Address - Phone:540-360-6106
Mailing Address - Fax:540-301-2134
Practice Address - Street 1:1329 ALUM SPRING DR. STE 202
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8011
Practice Address - Country:US
Practice Address - Phone:540-693-0380
Practice Address - Fax:540-301-2134
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0135530103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst