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Individual

MR. MARK BOOTHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1629 K ST NW, WASHINGTON, DC 20006-1602
(703) 754-0636
Mailing address
7230 HERITAGE VILLAGE PLAZA SUITE 202, GAINESVILLE, VA 20155
(703) 754-0636
(703) 754-0646

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC303556
DC

Other

Enumeration date
06/09/2014
Last updated
06/09/2014
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