Lucas Sidney Booth

NPI #1891335667 in Jamaica Plain, Massachusetts

Provider Information

NPI Number: 1891335667
Entity Type: Individual
Name: Lucas Sidney Booth
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Jan 9, 2020
Last Updated: Jan 9, 2020

Practice Location

Address: 157 GREEN ST
City: Jamaica Plain
State: Massachusetts
ZIP Code: 02130-2667
Phone: (617) 524-1120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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