Individual
SAMANTHA BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 380-9917
Mailing address
800 SCENIC DR, MODESTO, CA 95350-6131
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
08/10/2023
Last updated
08/31/2023
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