Mark Marcellus Booker
Technician, Personal Care Attendant in Laurel, MD. Individual provider (NPI-1).
NPI number1982439352
StatusActive
Last updated in NPPESSep 5, 2024
Details
- NPI
- 1982439352
- Entity type
- Individual (NPI-1)
- Name
- Mark Marcellus Booker
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 5, 2024
- Certification date
- Aug 30, 2024
- Last updated
- Sep 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
| 3747A0650X | Technician, Attendant Care Provider | – | – |
Practice location
10095 Washington Blvd N Apt 529Laurel, MD 20723-1963
Phone 202-993-6995
Mailing address
10095 Washing Blvd529
Laurel, MD 20743
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