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General NPI Number Information
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NPI Number | 1881553824
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Entity Type | Individual
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Provider Name | SHELLY BOOTH
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Gender | Female
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 3001 ARMAND ST STE L&I
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City | MONROE
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State | LA
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Zip | 71201-3754
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Country | US
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Telephone | 318-302-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 301 ARMAND STREET SUITE L&I
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City | MONROE
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State | LA
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Zip | 71201-9995
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | L-1048
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License Number State | LA
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