Individual
JOHN BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
520 N 28TH AVE, SUITE 200, WAUSAU, WI 54401-4101
(715) 845-4900
Mailing address
E1494 COUNTY ROAD Q, SCANDINAVIA, WI 54977-9727
(715) 467-2442
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
479-228
WI
Other
Enumeration date
09/25/2015
Last updated
09/25/2015
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