Individual
KELLY JO BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
914 WASHINGTON ST STE 7, PORT TOWNSEND, WA 98368-5746
(360) 643-0034
Mailing address
81 GLENDALE DR, SEQUIM, WA 98382-9730
(360) 461-7511
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
06/13/2017
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