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General NPI Number Information
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NPI Number | 1255680005
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Entity Type | Individual
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Provider Name | MARGARET CHRISTINE BOOTZ MA, CDP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 635 SW 154TH ST
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City | BURIEN
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State | WA
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Zip | 98166-2220
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Country | US
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Telephone | 360-789-3803
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Fax |
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Provider Business Mailing Address
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Address Line | 2405 CLIFFSIDE LN NW F-302
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City | GIG HARBOR
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State | WA
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Zip | 98335-1685
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Country | US
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Telephone | 360-789-3803
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC60277747
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CP00004449
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License Number State | WA
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