Provider Demographics
NPI:1679265557
Name:BOOKER, TAYLOR ALEXANDRA (LMSW)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXANDRA
Last Name:BOOKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75189-4071
Mailing Address - Country:US
Mailing Address - Phone:972-822-7031
Mailing Address - Fax:
Practice Address - Street 1:6780 HORIZON RD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-2103
Practice Address - Country:US
Practice Address - Phone:469-887-1802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105464104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker