Individual
MS. JO ANN BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1637
(636) 949-2650
(636) 949-2650
Mailing address
200 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1637
(636) 949-2650
(636) 949-2650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004635
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159912
PROVIDER ID
MO
01
—
465182
PROVIDER ID
MO
05
—
498219104
—
MO
01
—
99393746
PROVIDER ID
MO
Enumeration date
10/17/2006
Last updated
07/08/2007
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