Individual
MACKENZIE MAUREEN BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2021 CUNNINGHAM DR STE 400, HAMPTON, VA 23666-3371
(757) 838-1960
Mailing address
101 PINE CREEK DR, HAMPTON, VA 23669-1245
(360) 631-4350
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701008602
VA
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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