Individual provider · NPI-1
Rose M Boothe
Homemaker · Saint Louis, MO
NPI number1285990119
StatusActive
Last updated in NPPESJun 4, 2024
Details
- NPI
- 1285990119
- Entity type
- Individual (NPI-1)
- Name
- Rose M Boothe
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2012
- Certification date
- Jun 4, 2024
- Last updated
- Jun 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 376J00000X | Homemaker | 01151547 | MO | Yes |
| 3747P1801X | Technician, Personal Care Attendant | 01151547 | MO |
Practice location
8650 Moran Pl AceSaint Louis, MO 63114-4437
Phone 314-397-0905 · Fax 314-222-3394
Mailing address
8650 Moran PlSaint Louis, MO 63114-4437
Phone 314-397-0905 · Fax 314-222-3394
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