Healthcare Provider Details

I. General information

NPI: 1013830298
Provider Name (Legal Business Name): JAMISON L BOOZER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 GRUBB RD
MC KEAN PA
16426-1066
US

IV. Provider business mailing address

101 PEMBROKE CT
GREENSBURG PA
15601-6404
US

V. Phone/Fax

Practice location:
  • Phone: 724-396-1510
  • Fax: 724-972-4627
Mailing address:
  • Phone: 724-396-1510
  • Fax: 724-972-4627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC002630
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: