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1184661175
RAYDELL BOOTH
EAGLE, ID
NPI
1184661175
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: ID PSY211)
Enumeration Date
2006-05-31
Last Update Date
2020-02-19
Business Address
RAYDELL BOOTH PH.D.
4060 E CHINDEN BLVD
EAGLE, ID 83616-6481
Phone number: 208-377-1131
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Mailing Address
RAYDELL BOOTH PH.D.
13945 W WAINWRIGHT DR #106
BOISE, ID 83713-1925
Phone number: 208-377-1131
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