Organization
BOOTH PSYCHOLOGICAL SOLUTIONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYDELL J BOOTH PH.D. (PSYCHOLOGIST/OWNER)
(208) 377-1131
Entity
Organization
Contact information
Practice address
13945 W WAINWRIGHT DR STE 106, BOISE, ID 83713-1925
(208) 377-1131
(208) 908-7129
Mailing address
10 CREEKSIDE CT, GARDEN VALLEY, ID 83622-5294
(208) 377-1131
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY-211
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
10/18/2017
Last updated
10/18/2017
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