MEDICARE: VERONICA BOOKER MSW

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	33000755A	IN

General Provider Information

NPI Number	:	1306246947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA BOOKER MSW

Provider Business Mailing Address
First Line	:	2714 169TH ST
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-1508
Country	:	US
Telephone Number	:	219-554-0688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2714 169TH ST
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-1508
Country	:	US
Telephone Number	:	219-554-0688
Fax Number	:	219-554-1773

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

Provider Enumeration Date	:	09/02/2014
Last Update Date	:	09/02/2014

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Directions to “ VERONICA BOOKER MSW” Practice Location

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