Provider Demographics
NPI:1659166007
Name:BOOTHE, KRISTINA GARCIA (AMFT000869)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:GARCIA
Last Name:BOOTHE
Suffix:
Gender:
Credentials:AMFT000869
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 STAFFORD RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-4416
Mailing Address - Country:US
Mailing Address - Phone:904-305-0049
Mailing Address - Fax:
Practice Address - Street 1:1104 E 37TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-3313
Practice Address - Country:US
Practice Address - Phone:904-231-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMFT000869106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist