Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RAYDELL BOOTH, PH.D.
Active Sole ProprietorRAYDELL BOOTH, PH.D. is a Psychologist healthcare provider located in EAGLE, Idaho. NPI 1184661175 is currently active in the NPPES registry. Verify at CMS.
Psychologist · EAGLE, ID
Registration Details
- NPI Number
- 1184661175
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 31, 2006 (20.162461472597 yrs)
- Last Updated
- Feb 19, 2020
- License
-
PSY211 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4060 E CHINDEN BLVDEAGLE, ID, 836166481Browse ID providers · Browse ZIP 83616
- Phone
- 2083771131
- Fax
- 2083771171
- Primary Specialty
-
Psychologist
103T00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.