Grant Booth Pa Dba Booth Therapy | |
1499 Lincoln Ave Saint Paul MN 55105-2236 | |
(651) 690-1542 | |
Not Available |
Full Name | Grant Booth Pa Dba Booth Therapy |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 1499 Lincoln Ave, Saint Paul, Minnesota |
Authorized Official Name and Position | Grant Edward Booth (THERAPIST/CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 6516901542 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grant Booth Pa Dba Booth Therapy 1499 Lincoln Ave Saint Paul MN 55105-2236 Ph: (651) 690-1542 | Grant Booth Pa Dba Booth Therapy 1499 Lincoln Ave Saint Paul MN 55105-2236 Ph: (651) 690-1542 |
NPI Number | 1861915001 |
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Provider Enumeration Date | 07/19/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
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1861915001 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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