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Individual

JELANI AHMED WOOTEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
65 CADILLAC SQ STE 3000, DETROIT, MI 48226-2880
(313) 949-2693
Mailing address
65 CADILLAC SQ STE 3000, DETROIT, MI 48226-2880
(313) 962-6740

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
MI

Other

Enumeration date
01/17/2019
Last updated
01/17/2019
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