Provider Information for 1801487764
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Dr. BERNADETTE LATRICIA BOOZER-MADISON PHD, MSW, LMFT
Sex: Female
NPI: 1801487764
Last Updated: 2021-05-04
Certification Date: 2021-05-04
Certification Date: 2021-05-04
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1801487764 | ||||||||
| Enumeration Date | 2021-02-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5557 BALTIMORE AVE STE 5002040 HYATTSVILLE, MD 20781-1922 United States Phone: 202-810-3439 | Fax:301-560-1412 | ||||||||
| Primary Practice Address | 5557 BALTIMORE AVE STE 5002040 HYATTSVILLE, MD 20781-1922 United States Phone: 202-810-3439 | Fax:301-560-1412 | ||||||||
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