Individual
MRS. CARLY R BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCAS
Contact information
Practice address
4437 MAIN ST, SHALLOTTE, NC 28470-4451
(910) 754-4449
Mailing address
4437 MAIN ST, SHALLOTTE, NC 28470-4451
(910) 754-4449
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/22/2020
Last updated
12/04/2023
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