Individual
KRISTEN BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 LAKESHORE DR, RICE LAKE, WI 54868-1225
(715) 234-9101
Mailing address
1016 LAKESHORE DR, RICE LAKE, WI 54868-1225
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6079-26
WI
Other
Enumeration date
07/12/2017
Last updated
12/11/2018
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