Provider Demographics
NPI:1881867109
Name:BOOZER, CAISON FELTS (MSP, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAISON
Middle Name:FELTS
Last Name:BOOZER
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1214
Mailing Address - Country:US
Mailing Address - Phone:843-222-6081
Mailing Address - Fax:
Practice Address - Street 1:1421 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1214
Practice Address - Country:US
Practice Address - Phone:843-222-6081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist