Individual
STACY BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
53 CLARKWOOD ST, MATTAPAN, MA 02126-1807
(617) 690-9178
Mailing address
53 CLARKWOOD ST, MATTAPAN, MA 02126-1807
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW
MA
Other
Enumeration date
04/24/2013
Last updated
04/24/2013
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