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1548291842
JACK H BOOTH
SUMMERVILLE, SC
NPI
1548291842
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: SC 2674)
Enumeration Date
2006-07-05
Last Update Date
2007-07-08
Business Address
-- JACK H BOOTH Psy.D, LPC
709 OLD TROLLEY RD
SUMMERVILLE, SC 29485-5203
Phone number: 843-821-2480
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Mailing Address
-- JACK H BOOTH Psy.D, LPC
709 OLD TROLLEY RD
SUMMERVILLE, SC 29485-5203
Phone number: 843-821-2480
Copy
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