MEDICARE: SADIYAH SHAWNNA BOOTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	376J00000X	Homemaker
3	372600000X	Adult Companion

General Provider Information

NPI Number	:	1598638256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SADIYAH SHAWNNA BOOTH

Provider Business Mailing Address
First Line	:	515 HIGHLAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43610-1141
Country	:	US
Telephone Number	:	567-801-8357
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 HIGHLAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43610-1141
Country	:	US
Telephone Number	:	567-801-8357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2025
Last Update Date	:	09/27/2025

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Directions to “ SADIYAH SHAWNNA BOOTH ” Practice Location

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