Provider Demographics
NPI:1235412974
Name:BOOKER, CARLA
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:BOOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 ESMOND ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02121-4176
Mailing Address - Country:US
Mailing Address - Phone:857-241-7022
Mailing Address - Fax:
Practice Address - Street 1:72 ESMOND ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02121-4176
Practice Address - Country:US
Practice Address - Phone:857-241-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101Y00000XBehavioral Health & Social Service ProvidersCounselor