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General NPI Number Information
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NPI Number | 1285047696
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Entity Type | Individual
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Provider Name | DR. CAROLINE BOOTH
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Gender | Female
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 1601 E MARKET ST 349 PROCTOR HALL
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City | GREENSBORO
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State | NC
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Zip | 27411-0002
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Country | US
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Telephone | 336-334-7916
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 E MARKET ST 349 PROCTOR HALL
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City | GREENSBORO
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State | NC
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Zip | 27411-0002
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Country | US
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Telephone | 336-996-6265
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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 | 4259
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License Number State | NC
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