Leasonna Olivia Boozer, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

105498 Issued in TX

Practice address

15314 Albrecht LN
Selma, TX 78154-1849

Phone

(864) 706-9273

NPI assigned

Mar 21, 2007

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1821114935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15314 ALBRECHT LN",
            "city": "SELMA",
            "state": "TX",
            "postal_code": "781541849",
            "telephone_number": "210-890-8999",
            "fax_number": "210-890-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15314 ALBRECHT LN",
            "city": "SELMA",
            "state": "TX",
            "postal_code": "781541849",
            "telephone_number": "864-706-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOZER",
        "first_name": "LEASONNA",
        "middle_name": "OLIVIA",
        "name_prefix": "Miss",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Selma, TX
• Providers in Selma, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.