Individual
KAYLA BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
Mailing address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26968
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053535369
—
NC
Enumeration date
06/28/2021
Last updated
01/07/2022
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