Provider Demographics
NPI:1821423765
Name:BOOZY, KAREN (BA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BOOZY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 GROVE ST N STE 1
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2265
Mailing Address - Country:US
Mailing Address - Phone:727-895-5126
Mailing Address - Fax:
Practice Address - Street 1:506 GROVE ST N STE 1
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-2265
Practice Address - Country:US
Practice Address - Phone:727-895-5126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health