Individual
RAYDELL BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4060 E CHINDEN BLVD, EAGLE, ID 83616-6481
(208) 377-1131
(208) 377-1171
Mailing address
13945 W WAINWRIGHT DR #106, BOISE, ID 83713-1925
(208) 377-1131
(208) 377-1171
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY211
ID
Other
Enumeration date
05/31/2006
Last updated
02/19/2020
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