NPI 1245600840

John Booth, MFT

Practitioner Marriage & Family Therapist Wausau, WI

Practice location

Address: 520 N 28th Ave Suite 200, Wausau, WI 54401-4101
Phone: (715) 845-4900
Mailing address: E1494 County Road Q, Scandinavia, WI 54977-9727

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X Licence 479-228 (WI)

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Registry record

NPI: 1245600840
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Sep 2015
Record last updated: 25 Sep 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.