Individual
MRS. AMY LYNN BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DAILY LIVING AIDE
Contact information
Practice address
51505 TOWNSHIP ROAD 224, FRESNO, OH 43824-9028
(740) 545-5288
Mailing address
51505 TOWNSHIP ROAD 224, FRESNO, OH 43824-9028
(740) 545-5288
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
SD472594
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2589551
—
OH
Enumeration date
07/28/2006
Last updated
04/29/2008
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