Individual
BARBARA BOOTH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LIC
Contact information
Practice address
UNIVERSITY CAMPUS MC 2038 SAINT LEO UNIVERSITY, 33701 ST RD 52, SAINT LEO, FL 33574
(352) 588-8222
Mailing address
25317 TRADEWINDS DR, LAND O LAKES, FL 34639-5563
(813) 907-7414
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AL 1066
FL
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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