Raydell Booth, PH.D.

Psychologist · Eagle, ID

Individual Active NPI

NPI number 1184661175

Practice location

4060 E Chinden Blvd
Eagle, ID 83616-6481
Phone
(208) 377-1131
Fax
(208) 377-1171

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NPI record

NPI
1184661175
Entity type
Individual (Type 1)
Enumeration date
May 31, 2006
Last updated
February 19, 2020
Certified
February 19, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X PSY211 ID

Mailing address

13945 W Wainwright Dr #106
Boise, ID 83713-1925
Phone
(208) 377-1131
Fax
(208) 377-1171

About Dr. Booth

Raydell Booth, PH.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 4060 E Chinden Blvd, Eagle, ID 83616-6481. The NPI number 1184661175 was assigned on May 31, 2006 and the record was last updated on February 19, 2020.

Dr. Booth lists a license in the registry: #PSY211 (ID) for Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Raydell Booth, PH.D.?

The NPI number is 1184661175.

What is the phone number of Dr. Booth?

The phone number listed for the practice location is (208) 377-1131.

Where is Dr. Booth located?

4060 E Chinden Blvd, Eagle, ID 83616-6481.

What is the taxonomy code for Dr. Booth?

The primary taxonomy code is 103T00000X – Psychologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.