Booth, Renee Darlene

Booth, Renee Darlene is an individual health care provider with primary practice located at 1615 Mlk Blvd , Malvern AR 72104-2233. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Case Manager/Care Coordinator. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Booth, Renee Darlene can be contacted via phone (501) 332-5236.

Contact Information

Primary practice address
1615 Mlk Blvd Malvern AR 72104-2233
Phone: (501) 332-5236
Fax: (501) 620-5109
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X A0907062 Arkansas
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1699914275
LBN Legal business name Booth, Renee Darlene
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2009
Last updated Dec 30th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699914275 NPPES
Arkansas MEDICAID 116399726

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