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Organization
WINGS OF THE FUTURE CONSULTING PRIVATE PRACTICE
Active
Organization
WINGS OF THE FUTURE CONSULTING PRIVATE PRACTICE
Active
Other names
Wings of the Future Consulting Private Practice, Wings of the Future Consulting Private Pratice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRYSTAL MARIE BOOTHE LCSW (CEO/EXECUTIVE DIRECTOR)
(661) 402-1545
Entity
Organization
Contact information
Practice address
117 E COLORADO BLVD, PASADENA, CA 91105-1938
(661) 402-1545
(661) 727-0006
Mailing address
1308 ISLAND VISTA DR, ARLINGTON, TX 76005-1375
(661) 402-1545
(661) 727-0006
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-2422898
IRS
CA
Enumeration date
08/04/2021
Last updated
04/04/2025
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