Individual
TRACY LYNN BOOTH X
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
57 JACKSON ST, LONACONING, MD 21539-1307
(240) 609-9594
Mailing address
57 JACKSON ST, LONACONING, MD 21539-1307
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02311
MD
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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