Healthcare Provider Details

I. General information

NPI: 1003157843
Provider Name (Legal Business Name): TONI BOOTH M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2013
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 PLEASANT ST
CONCORD NH
03301-4006
US

IV. Provider business mailing address

PO BOX 2032
CONCORD NH
03302-2032
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-1551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: