| NPI | 1376817262 |
|---|---|
| Former Name | SHANNON BOOTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 103360) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12064) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2021-01-25 |