Individual
MISS CHRYSTAL MARIE BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
202 N WASHINGTON AVE, PULASKI, VA 24301-5022
(540) 994-2550
Mailing address
202 N WASHINGTON AVE, PULASKI, VA 24301-5022
(540) 994-2550
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133003687
VA
Other
Enumeration date
07/28/2021
Last updated
06/21/2024
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