Individual
KERRI BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 MAIN ST, GLASTONBURY, CT 06033-2218
(860) 430-1762
Mailing address
2300 MAIN ST, GLASTONBURY, CT 06033-2218
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
86
CT
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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