Individual
DAJIONNEA BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCMHT
Contact information
Practice address
805 HIGHWAY 589, PURVIS, MS 39475-4194
(601) 794-6543
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6342
MS
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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