Doctor Name: | KATELYN JEAN BOOHER |
NPI Number: | 1063736056 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 1222 S Patterson Blvd Ste 220 Dayton, OH - 454022684 |
Business Phone Number: | 9372235350 |
Business Fax Number: | 9372243112 |
Mailing Address: | 725 University Blvd, DAYTON |
State: | OH |
Postal Code: | 454350001 |
Phone Number: | 9372457100 |
Fax Number: | 9372457999 |
NPI Enumeration Date: | 03/18/2010 |
NPI Last Update Date: | 06/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |