Provider Demographics
NPI:1043677941
Name:BOOZE, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BOOZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 GRASSY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3772
Mailing Address - Country:US
Mailing Address - Phone:318-623-4563
Mailing Address - Fax:
Practice Address - Street 1:12907 OLD HAMMOND HWY SUITE I-4
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816
Practice Address - Country:US
Practice Address - Phone:225-246-8816
Practice Address - Fax:225-246-8816
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator