Provider Demographics
NPI:1396570602
Name:HOWELL, HAVEN BOOKER
Entity type:Individual
Prefix:
First Name:HAVEN
Middle Name:BOOKER
Last Name:HOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HAVEN
Other - Middle Name:GRACE
Other - Last Name:BOOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7723 ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-7253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13885 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-7621
Practice Address - Country:US
Practice Address - Phone:254-761-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122998235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist