Individual
AMANDA M BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20700 CIVIC DR, SOUTHFIELD, MI 48076
(800) 385-1035
Mailing address
35345 PHYLLIS ST, WAYNE, MI 48184-2908
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MI
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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