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General NPI Number Information
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NPI Number | 1164304093
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Entity Type | Individual
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Provider Name | REBECCA L BOOTH
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Gender | Female
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 759 SW FEDERAL HWY STE 215
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City | STUART
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State | FL
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Zip | 34994-2972
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Country | US
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Telephone | 609-713-5037
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Fax |
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Provider Business Mailing Address
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Address Line | 14325 SW MURNEY WAY
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-5833
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Country | US
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Telephone | 609-713-5037
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 22233
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License Number State | FL
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