Doctor Name: | MRS. KELLY JO BOOKER |
NPI Number: | 1306041017 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 3113 |
Business Practice Address: | 1 Siskin Plz Chattanooga, TN - 374031306 |
Business Phone Number: | 4236341703 |
Business Fax Number: | |
Mailing Address: | 20 Mason Dr Apt 1103, CHATTANOOGA |
State: | TN |
Postal Code: | 374156668 |
Phone Number: | 4232653259 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3113 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |