Organization
TRANQUIL HARBOR FAMILY THERAPY, JESSICA BOOTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA GLASSON BOOTH MS, LMFT, LCAS-A (MARRIAGE AND FAMILY THERAPIST)
(919) 498-4556
Entity
Organization
Contact information
Practice address
319 COURT SQ, SANFORD, NC 27330-5658
(919) 498-4556
(919) 708-9089
Mailing address
1062 HICKORY HOUSE RD, SANFORD, NC 27332-9193
(919) 498-4556
(919) 708-9089
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1843
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942682786
PERSONAL NPI NUMBER
NC
Enumeration date
08/30/2017
Last updated
08/30/2017
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