Provider Demographics
NPI:1609095876
Name:BOOTH, JOANNE ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:ELIZABETH
Last Name:BOOTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PENNINGTON LAWRENCEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-3212
Mailing Address - Country:US
Mailing Address - Phone:609-730-1167
Mailing Address - Fax:
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BUILDING 3, SUITE B
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:609-895-0775
Practice Address - Fax:609-895-0394
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100439900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical