Raya Booth
Individual provider Active NPI Athletic Trainer · Garrett, IN
NPI 1235502154 · NPPES record last updated Nov 2, 2015
Key facts
- NPI
- 1235502154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 1711 Shagbark CT
Garrett, IN 46738-1872 - Phone
- (260) 460-7234
- NPI assigned
- Nov 2, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
1711 Shagbark CT
Garrett, IN 46738-1872
Mailing address
1711 Shagbark CT
Garrett, IN 46738-1872
Other providers in Garrett, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.