Healthcare Provider Details

I. General information

NPI: 1306010459
Provider Name (Legal Business Name): CATHY JAMES BOOTH CCC-SLP, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2008
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 KINGSTON RD
PLAISTOW NH
03865-3043
US

IV. Provider business mailing address

65 KINGSTON RD
PLAISTOW NH
03865-3043
US

V. Phone/Fax

Practice location:
  • Phone: 603-382-8735
  • Fax:
Mailing address:
  • Phone: 603-382-8735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number242
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-07-3292
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6723
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0784
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: