Individual
BRENDA WILKINSON BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
440 BENMAR DR, SUITE 2295, HOUSTON, TX 77060-3165
(281) 201-5124
Mailing address
440 BENMAR DR, SUITE 2295, HOUSTON, TX 77060-3165
(281) 201-5124
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
66118
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170014444763
—
TX
Enumeration date
03/16/2014
Last updated
03/16/2014
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